Black and Hispanic patients with cancer and comorbid chronic conditions were less likely to receive high-complexity multiteam system (MTS) care than White patients. These findings were published in JCO Oncology Practice.

Multiple chronic conditions occur more frequently among patients with cancer, older patients, ethnic minorities, socioeconomically disadvantaged populations, and/or those living in rural areas. High-quality care for multiple chronic conditions likely requires high-complexity MTS care.

To evaluate whether access to quality care differs for certain patient groups, this study evaluated data from the SEER-Medicare linked database. Patients (N=75,201) aged 65 to 85 years who had multiple chronic conditions and breast, colorectal, or non-small cell lung cancer between 2006 and 2016 were evaluated for MTS care make-up. The complexity of MTS care was defined using Zaccaro’s theory of classification, in which high-complexity care was defined as having 4 or more clinicians from 2 or more specialties or 3 clinicians from 3 specialties.

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The total population comprised patients who were Black (8.0%), Hispanic (4.9%), and lived in rural areas (16.9%). The noncancer chronic conditions were diabetes and cardiopulmonary disease (n=25,926), cardiopulmonary disease (n=24,909), and hypertension (n=24,366).

Overall, 50.3% and 49.7% of patients received high- and low-complexity MTS care, respectively. The most common team compositions were oncology plus primary care (37.0%) and oncology, primary care, plus medical subspecialty (32.4%).

Receipt of high-complexity MTS care was associated with lung (incident difference [ID], 11.3%) or colorectal (ID, −16.6%) cancer compared with breast cancer; Black (ID, −6.7%), Hispanic (ID, −4.7%), and other (ID, −3.4%) ethnicity compared with White ethnicity; age 81to 85 (ID, −2.0%),76 to 80 (ID, 1.9%), or 71 to 75 (ID, 1.5%) years at diagnosis compared with 66 to 70 years; and living in a rural area (ID, −13.1%).

This study found evidence that more underserved populations with multiple chronic conditions were more likely to receive low-complexity MTS care.


Doose M, Verhoeven D, Sanchez JI, McGee-Avila JK, Chollette V, Weaver SJ. Clinical multiteam system composition and complexity among newly diagnosed early-stage breast, colorectal, and lung cancer patients with multiple chronic conditions: a SEER-Medicare analysis. JCO Oncol Pract. 2022;OP2200304. doi:10.1200/OP.22.00304