April is National Minority Health Month. One of our priorities at the American Cancer Society Cancer Action Network (ACS CAN) is supporting public policies that work to eliminate disparities in cancer research, screening, diagnosis, treatment and survivorship. Despite advancements in all of these areas, racial and ethnic minorities are more likely to develop cancer, and die from it, than the general U.S. population. They bear a greater cancer burden, largely due to factors such as poverty and lack of access to prevention, early detection and high-quality treatment services. African Americans in particular are more likely to develop and die from cancer than any other racial or ethnic group.
In an effort to increase awareness about these issues and encourage lawmakers to support legislation aimed at sustaining NIH funding levels, reducing financial burdens on patients and ultimately eliminating health disparities, ACS CAN joined three of our public health and research partners to co-host a Congressional briefing last month. The briefing, From Discovery to Delivery: Research at Work Against Cancer, featured four researchers representing different sectors of the research continuum alongside a patient to illustrate the value of federally-funded research in preventing and treating cancer. I'm pleased to have one of these researchers, Dr. Jan Eberth, Ph. D., assistant professor of epidemiology and biostatistics in the Cancer Prevention and Control Program at the University of South Carolina, highlight some of her own health disparities work below, along with highlights from a recent summit examining these issues.
The theme for the 2016 National Minority Health Month is "Accelerating Health Equity for the Nation". In the context of cancer prevention and control, this focus is particularly relevant. Over and over again, research studies have shown significant differences in access to cancer care and the quality of treatment received in minority and vulnerable populations. Achieving the highest level of health for everyone will require creative and sustained efforts to eliminate intended and unintended practices that drive inequalities. We cannot stack the health care and payer system against those with the greatest needs.
In 2015, the National Institutes of Health (NIH) and the American College of Surgeons had a summit to set an agenda for surgical disparities research, one area in which disparities have been observed for cancer patients. The recommendations from the summit, published in JAMA Surgery last month, urge researchers to go beyond the study of individual risk factors. Taking a broader view, attendees expressed that researchers should prioritize provider-, institution-, and system-level factors. Among the top research priorities identified (24 in total) were evaluating clinician-patient communication, interventions to reduce implicit bias, payment and incentive strategies and strengthening safety-net hospitals.
In a recent congressional briefing co-sponsored by ACS CAN, Celgene, AcademyHealth, and Research!America in Washington, D.C., cancer researchers and patient advocates, including myself, addressed a packed room of congressional staff and community affiliates with one goal to highlight the impact of research funding on cancer discoveries across the cancer continuum.
As an early career scientist, federal and foundation grants have helped catalyze my career and the discovery of systematic and preventable cancer disparities in my home state of South Carolina and nationwide. For example, during my NCI-funded postdoctoral fellowship at MD Anderson Cancer Center, my mentor Dr. Linda Elting and I uncovered substantial variation in the availability of mammography over time throughout the United States. In 2008, 10% more women were living in areas classified as having poor mammography capacity than in 2002.
In another recent study, we found that African American women in South Carolina fared worse than their white counterparts on every treatment quality variable assessed, including timely radiation therapy and chemotherapy administration, use of tamoxifen for hormone receptor positive breast cancers, and breast-conserving surgery rates. By uncovering these disparities, policies and programs can be developed and tailored to the populations affected, moving us further towards a reality of health equity.
The true costs of cancer are heavy, they are deep, and they are ultimately unaffordable for many, a challenge further exacerbated by this year’s COVID-19 pandemic and spotlighted by the upcoming Supreme Court case challenging the Affordable Care Act.