Cancer is often a disease that leaves the patients and families feeling helpless. This is understandable. When the cells you’ve trusted to keep you healthy, start to behave in unnatural, dangerous and aggressive ways, destroying your organs without intention of stopping one is justified in feeling helpless. But alas, we will not yield! Cancer research has come so far in the past few decades that more and more people can call themselves survivors. Two important facts that research has proven is that prevention is always better when possible, and that early diagnosis is the key to a favourable outcome. I’m a strong advocate of prevention especially when it comes to saying no to cigarettes. And I’m also well aware of the importance of screening to early diagnosis. Today however, let’s consider another aspect of awareness; that of inequity of access to Cancer Care.
There is currently disparity between the care necessary for early diagnosis among different populations. This leads to more dire consequences for those facing the inequity. Some populations facing inequity include black women, indigenous populations, the elderly, those of lower socioeconomic status/geographic region and rural populations. World Cancer Day this year did an amazing job at highlighting the inequities. We can use this information to pay closer attention to these populations, advocating for and taking special care of them when we can. If you have family, friends or community members in these populations, you should be aware of the following important facts.
Black women and cervical cancer
Cervical cancer is one of those that we can screen for. Pap smears have helped us reduce the incidence of and severity/progression of cervical cancer. Although ages vary globally, the general idea is that women that are sexually active or those in their early twenties should have pap smears done every 1-3 years. This allows us to find abnormal cells on the cervix and address the problem even before it is classified as cancer. Unfortunately, the disparity is such that for white women in the US, the five-year survival rate for cervical cancer is 71%. For black women, the rate is just 58%. Take extra care with your pap smears and follow ups black women!
The dreaded childhood cancer
Childhood cancer is one of the most devastating diagnoses to go through. One of the most common childhood cancers is that of leukemia, a cancer of the blood cells. The procedures and treatments that children have to go through include, chemotherapy port placement, chemotherapy, bone marrow biopsies, imaging sometimes under sedation, weeks in the hospital and occasionally even surgeries. Thankfully, several childhood cancers are actually cured after grueling but effective treatment. The disparity though is such, “childhood cancer survival rates are over 80% in high-income countries but as low as 20% in low-income countries. Great vigilance is required by those in low to medium income countries.”
Cancer and the elderly
Increasing age is generally a risk factor for most types of cancer and yet, older ages are being treated inequitably in cancer care. They are not being treated fully, not being included in decisions regarding their care, not getting enough support and counselling care, and not enough research is being done on elderly patients and best practices of care despite the aging world population. According to the statistics from World Cancer Day, “cancer kills nearly 10 million people a year and some 70% of those are aged 65 or older, yet older populations face disproportionate barriers to effective treatment.” Be very careful about paying extra attention to those older cancer patients who are at risk of inequitable care.
Indigenous Populations
The most important part of understanding equity is that it is different from equality. Years of ignorance of indigenous culture, practices, years of oppression and discrimination, means that more care needs to be taken to understand cancer’s acquirement and progression in indigenous populations and afford them greater resources to overcome the barriers, in a way that is respectful to their traditions. However, in New Zealand for example, the Māori are twice as likely to die from cancer as non-Māori.
Cancer awareness therefore goes beyond tools of prevention, treatment and cure, but extends into understanding that each population may require different care depending on need and years of being underserved.
M Parley 