Apr 11, 2017 3:00 AM

diverse group of people

Health equity is a priority for Huntsman Cancer Institute (HCI) and University of Utah Health. 

Cancer research has produced many advances in cancer prevention and treatment. But not everyone has been able to benefit equally from that progress. Some races, ethnicities, and population groups experience higher rates of cancer diagnoses and cancer deaths than other groups. These are known as cancer health disparities.

In Utah, one example of a disparity is low numbers of cancer screenings compared to the rest of the United States, says Ana Maria Lopez, FACP, MD, MPH, director of Cancer Health Equity at HCI and Associate Vice President for Health Equity and Inclusion at University of Utah Health. For example, according to the Utah Department of Health's Complete Health Indicator Report of Cervical Cancer Screening (Pap), the percentage of Utah women aged 18 or older who reported receiving a Pap test within the last three years decreased from 88.2 percent to 74.0 percent. 

“The whole reason for screening is to find the disease early when it is curable,” says Lopez. “The worst thing, for me as a clinician, is to see a patient with metastatic disease when that disease could have been prevented.”

Lopez says one reason behind the low screening numbers is a shortage of clinical services in rural communities. “With Utah being a very rural state, it’s hard for people to get to health care providers,” she says. Cost, language differences, and cultural differences can also be barriers.

HCI is committed to reducing cancer health disparities in the Mountain West through several programs:

  • The NCI’s National Outreach Network provides HCI with a Community Health Educator (CHE) to address health disparities in four rural health districts in Utah. For example, the CHE at HCI travels to these areas to teach the community about the importance of getting cancer screenings. “People need to know that screening makes a difference—that when disease is found early, a cure is possible,” says Lopez.
  • The HCI Center for Health Outcomes and Population Equity (HOPE) brings together scientists dedicated to improving cancer prevention and control among rural and frontier residents and other underserved populations including individuals living in poverty, Native Americans, Hispanics, and African Americans.
  • The HCI American Indian Program works with Utah's eight Native American Tribes and Nations to provide culturally competent education about cancer and has established formal agreements to support research partnerships. 
  • The Kepka Group, led by Deanna Kepka, PhD, is engaged in population science research that addresses health disparities related to cancer risk in vulnerable populations. The group focuses on the low rate of human papillomavirus (HPV) vaccination in Utah and cervical cancer prevention among U.S. Latinas. Despite strong evidence of the efficacy and safety of HPV vaccines, the use of this vaccine among adolescents in Utah is lowest in the nation.
  • Proyecto ESCALA, led by the Kirchhoff Group, seeks to understand the clinical care experience of Spanish-speaking caregivers and identify barriers they face with navigating the health system for their child with cancer. Findings from this study will help in designing tailored clinical practice interventions for Spanish-speaking families.
  • Patient navigators are trained, culturally competent health care workers who work with patients, families, physicians, and the health care system to make sure cancer patients are getting the care they need. HCI offers a patient navigation program for Spanish-speaking patients, who may have extra difficulty because of language and cultural differences.
  • HCI houses the PathMaker Research Program for students from underrepresented or disadvantaged populations. Students partner with an HCI investigator to learn about and perform cancer research. This gives them the opportunity to consider careers in biomedical research and health care. “Being able to support an inclusive health care workforce is really important in providing good care,” says Lopez.
  • Salud Juntos is a promotora-led home-based cancer care support solution project intended to reduce health disparities by developing medical technologies that are effective, affordable, culturally acceptable, and easily accessible to those who need them. The project is based on the well-established partnership between BrightOutcome and Dr. Lopez. The research team will co-develop a bilingual high tech and high touch medical care support portal for Latinos, the most rapidly growing group in the United States.
  • HCI provides free skin cancer and oral cancer screenings to make these early-detection services more accessible to people without health insurance.
  • The HCI Patient Education Resources portal is a comprehensive, searchable document library of materials ready to print on demand and updated on a three-year cycle. As of February 2017, the portal holds 243 custom factsheets in English. The most frequently used factsheets and those about blood and marrow transplant are available in Spanish currently. Translation of all custom factsheets is scheduled for completion later this year.


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