Disparities in clinical cancer detection and treatment
Cancer disparities can be created in the very places where they are supposed to be addressed: health care settings. For this reason, UC Davis researchers are examining institutional barriers to excellent cancer care for members of all groups. This work aims to even the playing field for access to clinical trials, and all treatment modalities for men and women of all ages and ethnicities.
Our research includes:
Men from lower socio-economic groups have worse outcomes for prostate cancer
Theresa Koppie, a professor of urology who treats prostate cancer patients, knows that regardless of the grade or stage of their disease, men who are from lower socio-economic groups have worse outcomes than those who are from higher socio-economic groups. Her work, funded by the Department of Defense, examines patterns of care and their impact on outcomes. The goal is to identify areas where quality improvements can be made to benefit patients.
Disparities in cancer pain management
Racial and ethnic minority patients with cancer have a harder time controlling their pain than do their white counterparts. With this in mind, Richard Kravitz, vice chair of the Department of General Medicine at UC Davis, conducted a study that determined that patients who received coaching to manage their pain and improve communication with their caregivers about pain control, reported far better pain control.
Disparities in breast cancer treatment
Steve Martinez, a cancer surgeon, is engaged in several research projects to better understand disparities in the treatment of women with breast cancer. He is working to determine whether women in more rural areas of the Greater Sacramento region have lower rates of breast reconstruction after mastectomy. Other research by Dr. Martinez has determined that blacks and Hispanics with advanced breast cancer are less likely to receive radiation therapy than their white counterparts, but that only black patients have poorer overall survival relative to whites. This finding suggests that a lack of radiation therapy is not likely responsible for poorer outcomes among black patients.
Minorities under-represented in clinical trials
Minorities make up an increasing percentage of the U.S. population, yet Asians, Hispanics and African-Americans continue to be under-represented in cancer clinical trials. A new research program entitled EMPaCT (Enabling Minority Participation in Clinical Trials) unites disparities experts from five NCI-designated cancer centers around the country, including UC Davis Comprehensive Cancer Center, to find models to increase minority recruitment into trials. The hope is that enrollment of more minorities will result in more targeted therapies for cancer patients.
African Americans less likely to undergo invasive surgical procedures for cancer detection and treatment
African Americans are less likely to undergo certain surgical procedures to determine the stage of their cancer or to have surgical treatment once staging is established. For that reason, African Americans generally have lower lung cancer survival rates than white patients. What is not known is whether these same disparities exist with the use of newer, non-invasive approaches to determine disease stage. UC Davis researchers are working with statewide cancer surveillance data to find out the proportion of invasive and non-invasive procedures (PET scans) being done in different groups, and if non-white patients are receiving PET scans at the same rate as white patients.