For our discussion we used the NCI definition of cancer health disparities "adverse differences in cancer incidence (new cases), cancer prevalence (all existing cases), cancer death (mortality), cancer survivorship, and burden of cancer or related health conditions that exist among specific population groups in the United States. "
Below, please find a sample of the responses to our questions. To read the full transcript please visit this page on Symplur.
- Lack of access to regular screenings puts underserved groups at a higher risk for developing cancer-related malignancies
- Medical "literacy." How close you live to healthcare, especially great healthcare, and how willing you are to go there. Also income, health insurance, and how good that insurance is
- There are historic factors, race, socio-economic, edu, & access, but there's also the not talked about, systemic & provider,
- Poverty, isolation, lower socioeconomic status, race, ethnicity, lack of insurance, disenfranchised, mental illness
- Racial/ethnic differences, genetic factors, rural-urban status--both cultural norms spatial access concerns--, socioeconomics
- Poverty, socioeconomic status, poor education, mistrust of medical profession (warranted in some groups
T2: What are some of the effects of health disparities you see in the experience of gyn cancer diagnosis, treatment, and beyond?
- So many ways that disparities rear their ugly heads- delayed diagnosis, inadequate care, inadequate access to supportive care
- In poorer comms, est 24% of providers admit they don't even discuss CATs or survivorship w/ minorities
- With cervical cancer and precancer, access to screening and follow-up! when something found definitely impacted by disparities
- Studies have shown <50% of women w/ ovarian cancer meeting genetic testing criteria, are referred for genetics + differences by race
- Some women--like those in rural areas-- sometimes don't get regular pap smears leading to later stage at dx and poorer outcomes
- Health disparities, particularly with access, results in fewer minorities participating in #clinicaltrials
- Much of research blames patient Social Determinants Of Health 4 disparities but lack of culturally-appropriate & buy-in providers is definitely a factor
T3: Which populations are most affected by these cancer disparities? What are some groups and resources addressing the issues?
- Health disparities also exist among LGBT population - summary article by G. Quinn at Moffitt: https://t.co/5eD2xDBk4a
- Recent disparities data shows African American women as 40% more likely to develop #cervicalcancer
- Risk for health disparity= anyone! Gyn cancers can be rare, and not all health care systems are created equally knowledgeable.
- African American women are disproportionately affected by cancer disparities. Esp rates of increase
- The recent re-adjustment on cervical cancer stats showed disparity greater than thought for African American and Hispanic women
- There are also biological factors contributing to disparities in cancer #uterinecancer p53 & USC
T4: What role does past research play in how disparities arise? What role does future research play in addressing disparities?
- Great opportunity to reduce disparities through CBPR and community engaged efforts in addtion to NGOs, NCI, and other orgs
- Cancer research already limited for women. Diversity within the women studied is a barrier.
- Researchers should make intentional effort to include diverse populations in studies,not just the patients conveniently available
- It is on the investigator to include underserved groups - it can't just be a "convenience sample"
- For historic data to play a role in epidemiology research, data has to be actionable. We need better analyst and data scientist
- @SGO_org is launching a campaign around #Trials4GynCancerNow Check the #gyncsm blog heading into next week to support
- Henrietta Lacks! Highlighting past research transgressions can,hopefully, reduce future disparities, improve trust in research
- The #CAPfoundation is trying to help with screening in populations underserved populations https://t.co/DpeOQpr867
- Researchers can also study ways to change or reduce cancer prevention, diagnosis & tx disparities to help prevent future cancers
- @mdandersonnews has a department that focuses on how to increase minority involvement in clinical trials and research studies
T5: How can we work together to address and reduce gyn cancer health disparities in our own communities and beyond?
- As a @GeneticCouns, while only one person, I help underserved women access counseling and testing
- continue to raise awareness so that increased funds can be directed toward this issue
- We know patients of gyn oncs better outcomes. Train more gyn oncs for underserved communities
- 5 Work to encourage funding 4 GynCa programs that support SDOH initiatives. Insist disparity disruptors get funded
- Promote #clinicaltrial awareness - Less than 2% of NCI studies have enough minorities to meet NIH goals
- Increased collaboration in academia and beyond --partner instead of compete for research/outreach $-->synergistic research etc
- The @C3Prize seeks answers to these cancer treatment challenges annually. Collaborate on a project. Get it funded.
- partnering with others who are passionate, like @ShewithLynch to raise awareness of disparities in hereditary cancer
- hopefully support for physicians to provide telemed might move the needle in that direction to ⬆ access
- working on a government and health policy level can help reduce health disparities... healthcare in flux=opportunity to improve
We ended out chat as we always do with Today I Learned. Some of today's thoughts were:
- Final thought. Be brave enough to discuss disparities in professional health comms. Our greatest resource is our resolve to "care"
- TIL that our community= passionate re: eliminating gyn cancer disparities! We can join together to raise awareness & promote change
- TIL health Disparities are deep within the fabric of of health care and will require education and active reform.
- TIL: The complexity of health disparities is great - but the passion to eliminate these disparities exists and will drive us forward
Remember you can always continue the conversation on the Smart Patients Platform ( https://www.smartpatients.com/partners/gyncsm ).
The SGO Meeting (#SGOMtg) takes place from March 12-15. @SGO_org is launching a campaign around #Trials4GynCancerNow. Check the #gyncsm blog heading into next week to support this effort.
We hope you will join us on April 12, 2017 as we discuss research results reported on at the SGO meeting during our SGO Research Review and ASK the Docs Chat.
See you then.
NCI Cancer Health Disparities Fact Sheet (including cervical cancer overview)
Approaching Health Disparities From a Population Perspective: The National Institutes of Health Centers for Population Health and Health Disparities https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2509592/
Disparities in Gynecological Malignancies https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4761838/
Racial Disparities in Cervical Cancer, Worse Than We Thought http://onlinelibrary.wiley.com/doi/10.1002/cncr.30501/full
SGO Taskforce Report on Gyn Cancer Disparities https://www.sgo.org/wp-content/uploads/2014/05/Collins-et-al.pdf
CDC Health Disparities and Inequality reports https://www.cdc.gov/minorityhealth/chdireport.html
Cancer and Lesbian, Gay, Bisexual, Transgender/Transsexual, and Queer/Questioning Populations (LGBTQ) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4609168/
National LGBT Cancer Network @cancerLGBT http://cancer-network.org/
Society of Gynecologic Oncology @SGO_org
National Society of Genetic Counselors @GeneticCouns
NY Times: Wider gap in cervical cancer deaths https://www.nytimes.com/2017/01/23/health/cervical-cancer-united-states-death-toll.html?smid=tw-nytimes&smtyp=cur&_r=2
Cancer Mortality in the Mississippi Delta Region: Descriptive Epidemiology and Needed Future Research and Interventions http://muse.jhu.edu/article/648763
CAP Foundation's "See, Test & Treat" partners with Day of the Latina Woman program in Houston https://www.youtube.com/watch?v=7wysxxdmUAM&feature=youtu.be
Participation in Cancer Clinical Trials - Race-, Sex-, and Age-Based Disparities http://jamanetwork.com/journals/jama/fullarticle/198896
Diversity in Clinical and Biomedical Research: A Promise Yet to Be Fulfilled http://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1001918
NCI launches study of African-American cancer survivors https://www.nih.gov/news-events/news-releases/nci-launches-study-african-american-cancer-survivors
Does equal treatment yield equal outcomes? The impact of race on survival in epithelial ovarian cancerhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC2612941/
Opportunities and Challenges in Cancer Health Disparities Research
In Cancer Trials, Minorities Face Extra Hurdles
General info https://www.sgo.org/education/annual-meeting-on-womens-cancer/