Social and cultural determinants
Before improvements can be made in cancer prevention and mortality for different groups of cancer patients, the environmental, social and cultural factors that affect cancer incidence and outcomes must be addressed. Only when these factors are better understood can innovative and appropriate approaches to cancer prevention, enhanced treatment and survivorship programs be developed and implemented. At UC Davis Comprehensive Cancer Center, researchers are examining these differences so that every group has the best chance against cancer.
Our work on the social and cultural determinants of disparities includes:
Disparities in regular breast cancer screening for uninsured or underinsured populations
Every Woman Counts is a state program that provides regular breast cancer screening to women who are uninsured or underinsured. Joy Melnikow, professor of Family and Community Medicine and her colleagues at the Center for Healthcare Policy & Research are developing a cost-effectiveness model for the program to assist California health policy makers as they allocate resources for use of new screening technology. The model takes into account differences between film and digital mammography, state budget reductions that have limited enrollment and eligibility for the program and data on breast cancers found as a result of screening.
Exposure to second-hand smoke greater among less-educated Asian-American women
Elisa Tong, an assistant professor of medicine, is an expert in tobacco use among Asian groups. Most recently, she has determined that Asian-American women who are less educated are more likely to be exposed to second-hand smoke in the workplace or at home than those who are better educated, despite anti-smoking rules.
Migration effects on smoking patterns
Does migration change smoking behavior? A research study by Elisa Tong found that U.S.-born Mexican-Americans start smoking at an earlier age, but are more likely to quit than their counterparts in Mexico. And while Mexican-American smokers smoke slightly more than their Mexican counterparts, their rates of smoking are still about half that of non-Hispanic white smokers in the U.S.
Benefits to future generations affect patient participation decisions
Biospecimen collection from diverse populations can advance cancer disparities research, but blood and tissue collection from these groups lags that of other populations. A study by Elisa Tong found that when Cantonese-speaking Chinese-Americans participated in an education seminar on biospecimen collection, they were more willing to donate specimens for the benefit of future generations than were a control group.
Adherence to hormone therapy among Spanish-speaking women
Melnikow and fellow researcher Debora Paterniti wanted to understand factors associated with adherence to hormone therapy among Spanish-speaking women with breast cancer. They created focus groups to develop a survey on the topic.
Funds extend cervical cancer prevention effort
Lydia Howell, professor and chair of the Department of Pathology and Laboratory Medicine, researches disparities in cervical cancer screening. With a grant from the American Society of Cytopathology, the Department of Pathology and Laboratory medicine is working to improve outreach to high-risk populations to catch precancerous cervical lesions when they are most treatable. The funds extend longstanding efforts at the Paul Hom Asian Clinic, a student-run clinic that provides health-care services to the underserved Asian-American community in Sacramento.