Joint effort targets breast cancer
BY AMELIA HARPER
Sunday, February 25, 2018
A recent study published in the North Carolina Medical Journal focuses on the high incidence of the breast cancer in Twin Counties and how community responses have reduced that incidence over the past 10 years.
The report, entitled, “Responding to a Community's Concern: A Comparison of Breast Cancer Characteristics and Initial Treatment in Three Selected North Carolina Counties,” studies the issue in Edgecombe and Orange counties, but focuses on the results in Edgecombe County especially.
“The success of this effort in Edgecombe County highlights the critical way community and health care partnerships can work to address health equity,” Adam Zolotor, president and CEO of the N.C. Institute of Medicine and a co-publisher of the medical journal said in a press release. “This is just the type of partnership we hope communities will be thinking about as the NCIOM develops the concept of Accountable Care Communities in North Carolina.”
In 2007, Susan G. Komen for the Cure released a report citing Edgecombe County as having one of the highest breast cancer incidence and mortality rates in the nation. The report revealed an incidence rate of 185.3 per 100,000 population based on a 2003 statistic, which was an all-time high for Edgecombe County. Mortality rates for breast cancer in Edgecombe were higher as well. In Edgecombe County, 38 percent of women with breast cancer died from the disease compared to 26 percent nationally.
After the release of the Komen report, community partners in Edgecombe County joined forces with researchers from the Gillings School of Global Public Health at UNC-Chapel Hill to raise community awareness and coordinate breast cancer resources, the recent journal article said.
“It wasn’t just one person or one organization, but multiple organizations with a shared desire to address the concerning rates that were put out by the Komen foundation,” said Anissa Vines, lead author of the study and assistant professor at the Gillings School of Global Public Health. “They were willing to work together, leverage the support of each other and really tackle this situation.”
The community response team included the Opportunities Industrialization Center, Rural Health Group, Crossworks, Vidant Edgecombe Hospital, the Edgecombe County Breast Cancer Taskforce, the Carolina Community Network and others. These organizations received funding for their community efforts from the North Carolina Office of Minority Health and Health Disparities, the National Cancer Institute Center to Reduce Cancer Health Disparities and Susan G. Komen for the Cure.
Many of the community efforts in Edgecombe County already had been established in previous academic-community collaborations and were enhanced through grant funding, including a lay health advisor program that shared information about breast cancer screening at an innovative location: local beauty shops.
“Crossworks and other organizations were in the community,” Vines said. “They were in beauty shops. They were in the areas that are even more remote, with limited transportation, promoting breast cancer training, treatment and survivorship.”
These community efforts corresponded with a 16 percent decline in breast cancer mortality in Edgecombe County. However, the study, which compared Edgecombe, Nash and Orange counties, showed that there are still areas for improvement. The study revealed that women in both Edgecombe and Nash counties remain more likely to be diagnosed with advanced breast cancer compared to women in Orange County, a higher resource county. Black women in Edgecombe and Nash counties also were diagnosed with advanced breast cancer more often than black women in Orange County.
According to Vines and colleagues, breast cancer outcomes are influenced by several factors, including stage at diagnosis, tumor aggressiveness and hormone receptor status. Breast cancer remains the most commonly diagnosed cancer in women and the second most common cause of cancer deaths in the United States.
“Changes in health outcomes do not occur swiftly,” Vines said. “They take time and persistence — but more so, they require consistent, sustainable effort along with resources.”