New directions
Jennifer Dacey Allen, ScD (right), with DFCI staff member Athene Wilson, is studying inequities in the screening and treatment of breast and prostate cancer.
The CanCORS initiative is the newest, but not the only, Dana-Farber study dealing with inequities in cancer care and prevention. Among the other projects now under way:
1. "Healthy Directions," run by the Institute's Center for Community-Based Research (CCBR), focuses on underserved populations whose health habits and living conditions may increase their risk for cancer (see the Fall/Winter 2001 issue of Paths of Progress). The program encourages people to alter unhealthy behaviors, minimize their exposure to cancer-causing substances in the environment, and reduce risk factors such as smoking, physical inactivity, and poor diet. It is headed by Glorian Sorensen, PhD, MPH, director of the CCBR, and Karen Emmons, PhD, deputy director of the center.
"Inequities in cancer prevention and treatment are finally on the radar screen of research."
— Karen Burns-White, MS, assistant director of minority initiatives for DF/HCC
2. Studies have documented that low-income women may be less likely than other women to receive prompt care after mammograms that show irregularities, which may prove to be cancerous. Why such care may be delayed for low-income women of all races is the subject of a study led by Jennifer Dacey Allen, ScD, and Roberta Goldman, PhD, of Dana-Farber's Department of Adult Oncology. The study will examine what influences the receipt of timely follow-up care and whether emotional problems or lack of education deter some women from seeking that care.
Fredrick Li, MD, of Population Sciences
3. Allen is teaming up with Dana-Farber's Ricardo Wray, PhD, and Tim Gilligan, MD, to learn how African-American men's attitudes toward prostate cancer affect their willingness to be screened or treated for the disease. Black men have a 54-percent greater chance of developing prostate cancer than white men, and they're more than twice as likely to die from it. Allen and her associates plan to interview religious leaders and other representatives of the African-American community, and organize focus groups comprised of both black survivors of prostate cancer and those who have not had the disease. "Our aim is to understand African-American men's needs and concerns regarding prostate cancer and explore ways to increase their participation in prevention, screening, and treatment programs," she says.
4. The workplace presents people with two types of health hazards: physical perils such as fumes, noise, and dust; and social stresses such as job strain, racial discrimination, and sexual harassment. Researchers led by DFCI's Elizabeth Barbeau, ScD, MPH, of the Center for Community-Based Research are asking whether such hazards fall mainly on people in certain jobs or from certain racial or ethnic groups. To find out, they are surveying unionized workers from many backgrounds and occupations at employers throughout Greater Boston. "By talking to a diverse group of workers, we'll be able to learn more about social inequalities and health and how to reduce them," Barbeau says.
In October, Dana-Farber hosted a one-day conference titled "Reducing the Unequal Burden of Cancer" in American society. Organized by Frederick Li, MD, director of Population Sciences at the Institute, the event drew a large audience of researchers, care providers, community and government leaders, and cancer survivors and their families.
Karen Burns-White, MS
These and other projects mark a welcome infusion of energy into a subject that has largely gone unplumbed by research, says Bruce Chabner, MD, chief medical officer of the Dana-Farber/Harvard Cancer Care Center (DF/HCC), who is coordinating disparity-related research within the consortium. "We're building an inventory of the work currently being done around health disparities, and we'll be looking at ways to encourage collaboration among researchers throughout DF/HCC."
"Inequities in cancer prevention and treatment are finally on the radar screen of research," says Karen Burns-White, MS, assistant director of minority initiatives for DF/HCC, who is aiding Chabner in the project. "Building awareness of the issues is an important first step. The real goal is to design interventions that reduce inequities for all patients."
