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Disparities and the Impact on Cancer Care

AVBCC Highlights

Moderator Sybil Green, JD, RPh, MHA, of the American Society of Clinical Oncology, admitted at the start of a panel discussion exploring “Disparities and the Impact on Cancer Care” at the 2022 AVBCC annual conference in New York City that this was not a novel topic.

The 3 panelists—Robert Winn, MD, Director of the VCU Massey Cancer Center; Edith Mitchell, MD, MACP, FCPP, FRCP, Associate Director of the Sidney Kimmel Cancer Center – Jefferson Health; and Otis Brawley, MD, Associate Director of Community Outreach and Engagement for the Johns Hopkins Kimmel Cancer Center—are familiar allies in a yearslong effort to reform systemic biases that have made healthcare inaccessible for many in this country and are resulting in the deaths of more than 130,000 Americans each year, according to Dr. Brawley.

He was quick to point out that while disparities in healthcare are often discussed in relation to minorities, this is not strictly a racial issue. High school graduates and dropouts are twice as likely to die of cancer in the United States as college graduates are. That, he said, is true of all races.

“When I started my career in health disparity 30-some-odd years ago, we actually called it ‘minority health,’” Dr. Brawley said. “And as I finish my career, I find out the largest group of people who suffer from health disparities are white. They tend to be poor. They tend to live in rural areas. They overwhelmingly live in the south.”

Drs. Winn and Mitchell said a significant reason why establishing equitable healthcare has been such a challenge is because misinformation has been passed down among clinicians for generations.

“There was this myth that minorities didn’t want to participate in clinical trials,” Dr. Winn said. “Turns out, that’s not actually true. And yet, we all had our own implicit and explicit biases about why we wouldn’t get folks from these communities.”

Dr. Mitchell traced the underrepresentation of Black male doctors to the Flexner Report of 1910, which she said is still influencing medical education in various ways today. “That’s why I say we need to look at the contributing factors and do something about them, not just talk about them.”

She also encouraged the audience to increase screening for breast, cervical, colorectal, and lung cancers within their own community. That, Dr. Mitchell said, was a more immediate means to dramatically decrease cancer death rates across all races, ethnicities, and genders.

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