Cancer Disparities in the Spotlight at Ohio State Conference
While the issues that led to the organization of a recent Ohio State cancer disparities conference are complex, the event’s formation can be summed up simply: “It’s the right thing to do.”
That was the summary of Raphael Pollock, MD, PhD, director of The Ohio State University Comprehensive Cancer Center (OSUCCC), who then elaborated on the motivation behind the 4th Annual Cancer Disparities Conference hosted by the OSUCCC during his opening remarks.
“If we’re really serious about making an impact in the mortality rates (from cancer), we have to make strides in disparate populations, where we can impact the statistic the most.”
“The health of our nation is at stake”
During the event, Pollock and his fellow speakers pointed out several disparities that can be targeted by medical leaders hoping to improve health and wellness across populations: higher rates of several cancers among minority groups; diagnoses that come at later stages when cancers are hard to treat; fewer African Americans and other minorities enrolled in clinical trials; higher overall death rates, especially for black men.
“The population is changing, and in 2050 minorities will make up 50 percent of the population and, if we don’t address this issue the health of our nation is at stake,” said Edwin Jackson, DO, from the Division of Pulmonary Diseases at The Ohio State University Wexner Medical Center.
Among the efforts to address the issue currently underway at Ohio State is the conference itself, which was organized by Darrell Gray II, MD, MPH, an assistant professor in the Division of Gastroenterology, Hepatology and Nutrition, and the deputy director of the OSUCCC – James Center for Cancer Health Equity.
“My hope for this conference is that it opens people’s eyes to the opportunities for reducing disparities along the cancer-care continuum and activates them to take action through clinical care, research, education and/or community engagement to move us toward health equity,” Gray said. “We have many stakeholders here today, providers, researchers, community members, and leaders from local and national organizations, to foster an environment of collaboration as we change the paradigm in cancer disparities through science and community engagement.”
“We have improved… however, the disparities continue”
The conference’s keynote address was delivered by Edith Mitchell, MD, director of the Center to Eliminate Cancer Disparities at the Sidney Kimmel Cancer Center at Jefferson, who looked at successes of the past that may provide some blueprints for solving problems of the present and future.
“We have improved the survival rate for cancer in the United States (for minority populations), however, the disparities continue,” Mitchell said.
Notable among the successful efforts of the past is the introduction of Medicare and Medicaid in the mid-1960s. which Mitchell credited with helping to narrow the gap in hospitalization rates between whites and blacks from 30 percent to 17 percent from 1961 to 1968.
As Mitchell also pointed out, however, wide disparities still exist, including a 14 percent gap in cancer incidence rate—and a 33-percent difference in death rate—between African American and white men, while African American women die from cancer at a 16-percent higher rate than white women despite a 6-percent lower incidence rate.
Among the possible solutions cited by Mitchell included increased representation of minority populations in clinical trials, which showed promise during an initiative in Philadelphia.
“I noticed, with my colorectal (cancer) patients, only 7.9 percent of my African-American patients were in clinical trials and Philadelphia is 45 percent black,” she said. “I worked with my colleagues (at Jefferson and in Philadelphia) to set up programs with doctors throughout the community, not only for African Americans, but for Asian, Latino and Hispanic populations. We gave them information on colorectal cancer and clinical trials and made it easier for the doctors to refer them to us for clinical trials.”
The OSUCCC – James also has outreach programs that target minority and underserved populations, including free colorectal cancer screenings for uninsured and underinsured and a similar program to detect early-stage lung cancer.
“Build a culture of health”
While the efforts of healthcare professionals are paramount to eliminating cancer disparities in the U.S., members of minority populations can expedite that progress by “[building] a culture of health,” according to Joshua Joseph, MD, of the Division of Endocrinology, Diabetes and Metabolism at the Ohio State Wexner Medical Center.
Among the building blocks recommended by Joseph include a focus on lifestyle, including adherence to the American Heart Association’s Life’s Simple 7 list—intended, in part, to reduce the risks of diabetes and cancer—and minority-focused wellness efforts like the National African American Male Wellness Walk Initiative, a national program of community walks and health screenings founded in Columbus.
Joseph and Gray participate in the initiative, working with founder John Gregory, a two-time cancer survivor who spoke at the disparities conference.
“Black men are reluctant to have discussions about health,” he said, adding that his walk, which is now held in 16 cities, is all about “saving the lives of African American men and creating an awareness campaign that it’s OK to go to your doctor.”
Gregory was asked for advice on how to break through cultural barriers to better relate to minority patients.
“With African Americans, what’s most important are relationships. We have trust issues … so if you can build a relationship you can convince that person to do anything (in terms of their cancer care).”
Gray is optimistic and determined by nature—two of qualities that have helped him as a physician and advocate.
“We have the resources and the talent pool and the determination to change the paradigm of cancer disparities to one of cancer health equity,” he said. “We’re making a difference. But we still have a lot of work to do.”