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Disparities in cancer care: Perspectives from the front line

Published online by Cambridge University Press:  10 May 2013

Patricia A. Miller*
School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
Christina Sinding
School of Social Work, McMaster University, Hamilton, Ontario, Canada Department of Health, Aging and Society, McMaster University, Hamilton, Ontario, Canada
Patti McGillicuddy
University Health Network, Toronto, Ontario, Canada Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
Judy Gould
Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
Donna Fitzpatrick-Lewis
School of Social Work, McMaster University, Hamilton, Ontario, Canada
Linda Learn
Juravinski Cancer Centre, Hamilton Health Sciences, Hamilton, Ontario, Canada
Jennifer Wiernikowski
Juravinski Cancer Centre, Hamilton Health Sciences, Hamilton, Ontario, Canada School of Nursing, McMaster University, Hamilton, Ontario, Canada
Margaret I. Fitch
Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
Address correspondence and reprint requests to: Patricia A. Miller, 5 Undercliffe Avenue, Hamilton, Ontario, CanadaL8P 3G9. E-mail:



The purpose of this qualitative study was to investigate how frontline healthcare professionals witness and understand disparity in cancer care.


Six healthcare providers from a range of care settings, none with < 15 years of frontline experience, engaged with researchers in an iterative process of identifying and reflecting on equity and disparity in cancer care. This knowledge exchange began with formal interviews. Thematic analysis of the interviews form the basis of this article.


Participants drew attention to health systems issues, the meaning and experience of discontinuities in care for patients at personal and community levels, and the significance of social supports. Other concerns raised by participants were typical of the literature on healthcare disparities.

Significance of results:

Providers at the front lines of care offer a rich source of insight into the operation of disparities, pointing to mechanisms rarely identified in traditional quantitative studies. They are also well positioned to advocate for more equitable care at the local level.

Original Articles
Copyright © Cambridge University Press 2013 

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