In any diverse population, cancer health disparities are virtually certain to arise among people of different races or ethnicities, genders, socioeconomic backgrounds, geographic origins, and other distinctions. However, these disparities often defy easy explanation, making it very difficult for healthcare professionals to overcome them.
Rex Mowat, MD, of The Toledo Clinic Cancer Centers, elaborates, “We’re a very heterogenous group of human beings, so disparities are to be expected, and the reasons for them are highly complex and often interrelated. We see disparities in prevention, diagnosis, treatment, and outcomes—all across the board. We can’t always correct them, but whenever there’s a chance that we can fix them, we have to make the effort. I consider that a challenge worth taking.”
Dr. Mowat further explains that cancer care keeps getting better and outcomes have consistently improved for all groups. Nonetheless, disparities persist. “For example, African Americans, especially men but also women who have breast cancer, have worse cancer death rates than white people do. While the outcomes for African Americans have clearly improved over time, they’re still lagging, which means there’s more room for improvement,” he says.
Other examples of ethnicity-related disparities that Dr. Mowat identifies include Native Americans being more vulnerable than other groups to certain types of cancer, specifically gall bladder, stomach, and kidney cancer. Also, despite having a lower incidence for all cancers combined compared to white people, Hispanic people have a higher rate of cancers associated with infection, such as cervical, liver, and stomach cancers (related to infection with HPV, hepatitis, and Helicobacter pylori, respectively).
Are these disparities related to innate racial bias, lack of insurance, stigma associated with particular diagnoses, refusal of doctors to accept Medicaid, limited access to screening, poor medical care in general, genetics, or other factors? “It could be any or all of the above,” states Dr. Mowat. “We see all these factors playing a role, but it’s so complex and hard to sort out.”
In some cases, barriers to cancer care are a simple matter of proximity to services. For instance, someone living in the inner city who needs to see a doctor in the suburbs but has limited access to reliable transportation may be unable to keep appointments. The same could apply to an impoverished individual in a rural setting who can’t afford gas and lives 30 miles from the nearest doctor.
Notwithstanding the challenges that cancer health disparities present, the dedicated team of providers at The Toledo Clinic Cancer Centers continually strives to help overcome obstacles to treatment and achieve the best possible outcomes for patients of all backgrounds. One way they accomplish this is by adhering to national care protocols that are blind to race, age, sex, etc., but they’re also finding ways to be more proactive in leveling the playing field in our community. “For example, while it’s not finalized yet, we’re working on developing a partnership with the Neighborhood Health Association and Dana Cancer Center, whose goal is to provide equal access to quality medical care and support services to all community members. We’re partnering with NHA and Dana Cancer Center to help a very significant group who are underserved for a variety of reasons,” says Dr. Mowat.
Perhaps most importantly, The Toledo Clinic Cancer Centers providers treat every patient as a unique individual, not just as a representative of a group. “Treating every patient as an individual, taking into account any factors that could potentially lead to disparities in their diagnosis, treatment, or outcome, is the surest way to circumvent unconscious biases,” Dr. Mowat states.
The Toledo Clinic Cancer Centers, located at 4126 N. Holland Sylvania Road, Suite 105, also provides imaging, laboratory, chemotherapy and IV services. The cancer center consists of 8 medical and 2 radiation oncologists along with 8 nurse practitioners and 4 research nurses. The cancer center also has satellite centers in Maumee, Napoleon, Bowling Green, Wauseon, and Monroe.
The Toledo Clinic Cancer Centers has earned Patient-Centered Specialty Practice level 3 recognition and Oncology Medical Home recognition from the National Committee for Quality Assurance. Oncology homes align systems and resources with coordinated care focused on cancer patients and their needs. This reduces fragmentation, supports shared decision making, and improves the patient experience. They are the first oncology practice in the state of Michigan and the second oncology practice in the state of Ohio to receive this recognition.
For more information, please call The Toledo Clinic Cancer Centers at 419-479-5605.