As the only National Cancer Institute-designated comprehensive cancer center in Metro Detroit, Karmanos Cancer Institute is at the forefront of research and innovation. While our laboratory and clinical studies may be the first to come to mind, a great deal of extraordinary population-based research is being conducted here every day. We may visualize the bench when discussing research, but examining patient experience at the bedside is equally important. This is especially true when we consider disparities in care and inequity among those with cancer.
In July 2021, Michael Simon, M.D., MPH, co-leader of the Breast Cancer Multidisciplinary Team at Karmanos and a group of researchers from Karmanos Cancer Institute and Wayne State University published “A Review of Research Disparities in the Care of Black and White Patients with Cancer in Detroit” in Frontiers in Oncology. This detailed study compiles the work of Karmanos researchers in the Population Studies and Disparities Research Program. The group, along with collaborators, has spent the past three decades investigating racial disparities in cancer incidence, treatment and outcomes among Black and white patients in Southeast Michigan, with a specific focus on the Detroit area, a city with a majority Black population.
Using an organizational framework of three generations of studies on racial disparities, the review describes racial disparities by primary cancer site, disparities associated with the presence or absence of comorbid medical conditions, disparities in treatment and disparities in physician-patient communication, all of which contribute to poorer outcomes for Black cancer patients. The review also highlights evidence-based strategies that can help mitigate disparities, improve care for vulnerable populations and build an equitable health care system. Lessons learned can also inform a more equitable response to other health conditions and crises. The findings suggest that to reduce or eliminate racial disparities in cancer outcomes, it is also of utmost importance to address larger questions of inequality inherent in the legacy of structural racism in the US, along with disparities across the spectrum of chronic comorbid and medical conditions, which have a disproportionately negative impact on Black people.
The review is organized into three generations of cancer disparities research. First-generation studies are those that both identify and document the existence of health disparities. Second-generation studies are analytic or evaluative and attempt to assess variables that could potentially explain the noted disparities. Third-generation studies have the goal of testing interventions that could serve as solutions to mitigate disparate outcomes. A fourth-generation is also included, the purpose of which is to take action that may help in eliminating disparities.
The comprehensive and complete study is available here. This review captures the valuable work that has been done at Karmanos Cancer Institute to identify and understand disparities in cancer care. The critical task now is to put this information to use so we may create a more equitable system of care for patients.
Read the full study