According to the American Medical Association, racial and ethnic minorities experience a lower quality of health care, are less likely to receive routine care, and face higher rates of morbidity and mortality than nonminorities. When it comes to cancer patients, outcome disparities based on racial and socioeconomic factors are magnified, becoming even more severe.
Alexander B. Olawaiye, MD, professor of gynecologic oncology at UPMC Magee-Womens Hospital and member of the cancer therapeutics program at UPMC Hillman Cancer Center, focuses much of his work on how these disparities affect cancer care and cancer research specifically in women’s cancers.
“The disparities in women’s cancer care outcomes are staggering, this is a well-known fact,” says Dr. Olawaiye. “My work focuses on bringing attention to the disparities at every given opportunity and attempts to better understand the contributing factors. This is the only way to reduce and hopefully eliminate the disparities.”
The incidence, prevalence, and mortality from endometrial, ovarian, and cervical cancer are much higher in Black, Native American, Alaska Native, and Hispanic populations compared to white women. In addition to racial and socioeconomic disparities, there are also biological factors at play that cannot be attributed to disparities in health care tendencies or bias.
For example, Black women tend to have higher grade, more dangerous cancer histotypes when diagnosed with endometrial cancer, according to a research published in the International Journal of Gynecological Cancer. These cancers are more lethal, meaning the risk to the patient is higher from the beginning – regardless of socioeconomic or other external disparities. Researchers continue to investigate other areas e.g. genetics and how they affect populations differently, such as prevalence of certain cancers or how cancer responds to therapy.
Combined efforts from academic and community oncologists are necessary to address the socioeconomic and genetic factors that play a role in disparities in cancer care. By acknowledging these disparities, health systems can create more equitable standards for all patients.
Cancer research directly impacts these disparities in multiple ways. First, patients being treated on research protocols are subject to strict rules with limited variability from one group of patients to another, allowing researchers to know if there are true biological differences between groups that impact therapy outcomes.
Second, because clinical trial treatment can be protected from social factors, which are known to negatively impact outcome, cancer research is an excellent means of bringing attention to these social factors by allowing researchers and clinicians to compare outcomes of patients treated on research protocols to those of patients treated outside research protocols.
Third, cancer research almost always seeks to improve the current standard of care, so there is potential for participants to gain benefits that are not possible from the current standard of care. This potential opportunity, if extended to all segments of the society, can positively impact disparities in treatment outcomes.
“My contributions are helping to advance the field of gynecologic cancer therapeutics and because of collaborative efforts across other cancer sites, my work is helping toward advancement of cancer care overall,” says Dr. Olawaiye.
About Dr. Olawaiye
Alexander B. Olawaiye, MD, is the director of gynecologic cancer research at UPMC Magee-Womens Hospital and the Gynecologic Oncology Group Foundation principal investigator at UPMC Hillman Cancer Center. His research interests are both clinical and translational, but the majority of his research efforts are in clinical research involving gynecological cancers including ovarian, uterine, cervical, and vulvar cancers. These efforts are concentrated on drug development and advancement through phase II and III trials.
During his residency and fellowship trainings, Dr. Olawaiye realized that as an individual physician, the number of patients he could impact was limited, but research findings have the potential to impact unlimited numbers of patients directly and indirectly all over the world.
In the next 10 years, Dr. Olawaiye expects a significant stride in targeted gynecologic cancer therapeutics with an expansion of approaches that focus on increased efficacy and reduced toxicity. His work will contribute to this positive development by evaluating and validating precision therapeutics in gynecologic cancers.
Horne ZD, Teterichko SR, Glaser SM, Wegner RE, Hasan S, Crafton SM, Miller EM, Krivak TC, Viswanathan A, Olawaiye AB, Sukumvanich P, Beriwal S. Race-driven survival differential in women diagnosed with endometrial cancers in the USA. Int J Gynecol Cancer. 2020;30(12):1893-1901. doi:10.1136/ijgc-2020-001560
Written By: Annaliese Daniels
Reviewed By: Alexander Olawaiye
Last Updated: 3/13/2023