The unequal burden of cancer in the United States poses a challenge both to science and to society. In an effort to understand the causes of cancer health disparities and to develop effective interventions, Memorial Sloan-Kettering has established the Office of Diversity Programs.
Although important advances against cancer have been made in recent years, not all Americans are benefitting equally. There are groups for whom cancer statistics remain grim. For example, the US Department of Health and Human Services reported in 2004 that, over all, African Americans are more likely than any other racial or ethnic group to develop cancer. In turn, they have the highest cancer death rate of any racial or ethnic group.
To address disparities in cancer outcomes based on race, ethnicity, cultural differences, and socioeconomic status, Memorial Sloan-Kettering Cancer Center has established the Office of Diversity Programs in Clinical Care, Research, and Training. "Memorial Sloan-Kettering is already a leader in cancer prevention, screening, treatment, and research. We should also be a leader in the effort to reduce and eliminate cancer health disparities," said Memorial Sloan-Kettering Cancer Center gynecologic oncologist Carol L. Brown, director of the office.
The new office will launch Centerwide initiatives focused on strengthening existing Memorial Sloan-Kettering programs as they relate to diversity, as well as on developing new programs. "There is still a gap between what has been established as effective in reducing the burden of cancer and the availability and application of that knowledge to all people, regardless of where they live, whether they are rich or poor, or what their cultural backgrounds are," said Memorial Sloan-Kettering Cancer Center President Harold Varmus. "The Office of Diversity Programs will help us to better understand the basis for the unequal burdens of cancer and implement interventions to address them."
In clinical care, Dr. Brown's office will work to improve the use of Memorial Sloan-Kettering Cancer Center's screening, diagnostic, and treatment programs by minority groups, in addition to expanding the Center's outreach programs. These include the Ralph Lauren Center for Cancer Care and Prevention (RLCCP) -- a partnership between Memorial Sloan-Kettering and Harlem's North General Hospital -- and Memorial Sloan-Kettering 's Breast Examination Center of Harlem (BECH). "As we work with our existing partners to improve the screening, diagnosis, and treatment of cancer, we'll also be seeking new partners and collaborations," explained Dr. Brown.
Other efforts will include increasing the enrollment of minority patients in clinical trials throughout the Center. "We need to address the special barriers to trials experienced by minority groups, including trust and financial issues," Dr. Brown said. "There are methods to help patients overcome these barriers, such as patient navigators, a concept developed by RLCCP medical director Harold Freeman and used at BECH and the Ralph Lauren Center," she continued. Patient navigators guide patients through their cancer experience and ensure that they do not become lost in the complexities of the heathcare system.
The office will also coordinate clinical and laboratory research focused on the reduction and elimination of health disparities. "There are certain cancers in which there's a great disparity in survival," Dr. Brown said. "This may be because people are not receiving adequate treatment or the correct treatment. But there may also be differences in the type of cancer certain groups get or in the way they respond to treatment. Clinicians and scientists at Memorial Hospital and the Sloan-Kettering Institute are already conducting research in these areas. Our objective is to bring these investigators together to interact and exchange ideas, as well as to interest new investigators in doing similar research."
The third major focus of the office is training. "We want to improve our efforts in training members of underrepresented minority groups -- both those providing cancer-related healthcare, such as physicians, and those doing basic research," said Dr. Brown. Existing programs at Memorial Sloan-Kettering Cancer Center, including the Sloan-Kettering Institute Summer Undergraduate Research Program and the Summer Student Fellowship Program sponsored by the National Cancer Institute, give undergraduate and medical students opportunities to participate in laboratory and clinical research. Each summer, minority students come to Memorial Sloan-Kettering Cancer Center as part of one of these programs. Gateways to the Laboratory, another summer program, is aimed especially at disadvantaged and underrepresented freshman and sophomore college students interested in pursuing MD/PhD programs.
"We want to build on these programs and develop new ones," Dr. Brown said. "We'll also focus on recruitment and retention of minority physicians, scientists, and other healthcare professionals. Enhancing the diversity of our faculty and professional staff will allow Memorial Sloan-Kettering Cancer Center to remain competitive and effective in meeting the needs of all our patients."
