Background: While much of cancer research has historically centered on innovations within clinical or laboratory settings, most of the factors shaping equity in cancer outcomes reside outside hospital walls—in neighborhoods, workplaces, and community networks. This reality underscores the need for community-involved and community-living interventions: programs co-designed and delivered within communities to meet people where they live, work, and socialize. Such interventions hold the greatest promise for sustainability because they are embedded in the daily lives, cultures, and resources of the populations they serve. Methods: This special collection brings together research that illuminates the power of community-centered and community co-led strategies for prevention, early detection, treatment, and survivorship across diverse settings. Results: The articles in this series illustrate how innovation, cultural humility, and local engagement can bridge persistent gaps in cancer care. Conclusion: Together, they highlight how communities themselves are essential partners in dismantling disparities and achieving lasting cancer control.
According to the World Health Organization (WHO), “health inequities are systematic differences in the health status of different population groups. These inequities have significant social and economic costs both to individuals and societies.” This definition underscores the powerful influence of the social determinants of health (SDOH) and the systemic inequities that shape access to care, coverage, and quality of services. In the context of cancer, the U.S. National Cancer Institute (NCI) defines cancer health disparities as “differences in cancer measures such as incidence, prevalence, mortality, survival, morbidity, survivorship, financial burden of cancer or related health conditions, screening rates, and stage at diagnosis.” Despite decades of progress in cancer prevention and treatment, cancer health disparities (CHD) remain one of the most persistent and consequential challenges facing health systems worldwide, particularly among populations that have historically experienced social and structural disadvantage.
While much of cancer research has historically centered on innovations within clinical or laboratory settings, most of the factors shaping equity in cancer outcomes reside outside hospital walls—in neighborhoods, workplaces, and community networks. This reality underscores the need for community-involved and community-living interventions: programs co-designed and delivered within communities to meet people where they live, work, and socialize. Such interventions hold the greatest promise for sustainability because they are embedded in the daily lives, cultures, and resources of the populations they serve.
This special collection brings together research that illuminates the power of community-centered and community co-led strategies for prevention, early detection, treatment, and survivorship across diverse settings. The articles in this series illustrate how innovation, cultural humility, and local engagement can bridge persistent gaps in cancer care. Together, they highlight how communities themselves are essential partners in dismantling disparities and achieving lasting cancer control.
The research article described by Salinas and Odedina
1
focused on the “Virtual Community Oncology Navigation and Engagement (vCONET)” program. Developed with and for Black women, vCONET leverages a virtual platform to provide immersive, culturally relevant education on breast cancer risk, mammography, and prevention. The vCONET study demonstrated how technology can be adapted to community realities rather than imposed from outside. The study also revealed critical themes, including: the importance of tailored, repetitive messaging; the dual promise and challenge of virtual platforms for those less technologically adept; and the long journey of building trust between communities of color and healthcare institutions. Shaukat et al,
2
in their paper on “How the Tumor Boards Facilitation Forum (TEFF) Shapes the Breast Cancer Journey in Pakistan” show that community-living approaches are not confined only to digital platforms or high-resource countries. The TEFF in Pakistan exemplifies how system-level interventions can be rooted in community engagement. The initiative sought to standardize breast cancer care by facilitating tumor board structures that guide patient journeys “from diagnosis to survivorship.” TEFF demonstrated that community-living interventions can operate at both the individual and systemic level, ensuring continuity and quality of care across the cancer continuum.
Using grounded theory methodology, Fullwood et al
3
explored the communication preferences of Black prostate cancer survivors in the research article “Utilizing Communication Accommodation Theory to Address Black Men’s with Prostate Cancer Healthcare Preferences”. Data collection was fully decentralized with interviews conducted via telephone or by Zoom to better understand survivors’ communication preferences. Findings underscored the importance of cultural and racial perspectives in shaping post-treatment communication. Survivors consistently expressed a need for both face-to-face and telehealth options, with a strong emphasis on safe, supportive environments that encourage openness and vulnerability.
In the article, “Partnering With Faith Communities to Increase Knowledge of Precision Medicine and Genetic Research in the Black Community,” Dowe et al
4
described how collaboration between a cancer center and a network of urban Black churches improved awareness and interest in precision oncology and cancer clinical trials. Cancer center researchers and staff cultivated long-term relationships with Black faith community leaders, who co-led the development of “The Future of Medicine is Now” intervention and its delivery to church congregants. This study provided a compelling example of integrating intervention in church settings. In the study by Fowler et al
5
focused on “Refining Our ‘CRAFT’: The Community Research Academy to Foster RepresenTation (CRAFT) Program”, community health workers (CHWs) were central to the community-living intervention. As part of CRAFT, 21 CHWs were trained to engage diverse communities on clinical trials topics, including clinical trials myths and ways to find clinical trials on electronic platforms. In the cohort of predominantly Black CHWs trained, the majority demonstrated increases in knowledge across training sessions but still expressed strong interest in additional training and information. Such insights further support CHWs as interventionists who can “meet communities where they are” to address cancer needs.
“Understanding and Addressing Cancer Disparities Among American Indians in North Carolina: The Southeastern American Indian Cancer Health Equity Partnership (SAICEP)”by Bell et al
6
is a timely project targeting a highly disparate yet severely understudied population -- American Indians and Alaska Natives (AIANs). SAICEP was created as a partnership among North Carolina’s three NCI designated cancer centers and AIAN organizations with the mission to understand and address the burden of cancer in these populations. Built on the science of community engagement, SAICEP co-hosted educational webinars and directed community service to help communities understand and reduce cancer risks. Importantly, SAICEP is prioritizing closing the data gap by documenting cancer trends, and care barriers, and community needs for American Indians in North Carolina. These efforts hold the promise to inform effective community responsive and community-based care and prevention interventions for the indigenous communities in North Carolina and beyond.
The “Be Well Baytown: Whole-Community Cancer Prevention Initiative Based on Multi-Sector Capacity and Partnership Building” by Raber et al
7
described seven years of implementation of a multi-sector, whole community cancer prevention program. Be Well Baytown is a partnership among an academic cancer center and eight community organizations, guided by multisectoral Steering Committee. This community activation program implemented evidenced, community-based interventions to disrupt modifiable risk factors for cancer. The programs implemented included capacity building (i.e., technical assistance, program evaluation, sustainability planning, etc.). The authors reported sustained 7-year milestone with 93% of the city population reached in 2024. The annual increases in Steering Committee engagement, and within Committee collaborative activities demonstrated capacity building for community driven leadership and intervention for whole community impact.
The articles in this special collection advance a vision where cancer control is not an external imposition but a shared endeavor between health systems and the communities they serve. They collectively argue that addressing cancer disparities requires more than clinical excellence—it demands reimagining the very settings and methods through which prevention, treatment, and survivorship support are delivered. Collectively, the interventions reported in this collection highlight essential principles for sustainable cancer control:
1. Co-creation with communities. Solutions that emerge from collaborative partnerships are more likely to address real-world barriers, from digital literacy to transportation challenges.
2. Cultural and contextual tailoring. Effective programs acknowledge and integrate cultural norms, language, and community values rather than assuming one-size-fits-all models.
3. Trust-building as a process. Particularly in marginalized populations, mistrust of health systems cannot be erased with a single intervention. Continuous, visible commitment from healthcare providers and researchers is required.
4. Integration into existing infrastructures. Sustainability depends on embedding interventions into the fabric of community life—whether through neighborhood organizations, virtual environments familiar to participants, or local healthcare systems.
5. Global adaptability. Though cancer disparities manifest differently worldwide, the core principles of equity, community partnership, and sustainability remain universal.
Cancer control cannot be sustainable without community ownership. By embedding interventions in the rhythms of everyday life, we can move closer to a future where equity is not aspirational but expected.
