This May, Timothy J. Eberlein, MD, Bixby Professor and Chair of the Department of Surgery, delivered the Humanities in Surgery lecture at the annual scientific meeting of the American Society of Colon & Rectal Surgeons (ASCRS) in Tampa.
During his lecture, titled “Can a Department of Surgery Reduce Disparities and Improve Health Equity?,” Eberlein highlighted the accomplishments of programs in the Mary Culver Department of Surgery at Washington University School of Medicine in St. Louis aimed at improving health equity and eliminating disparities in health care.
Through partnerships with Alvin J. Siteman Cancer Center, area hospitals, churches, and community organizations, as well as utilizing the expert investigators of the Division of Public Health Sciences, in the Department of Surgery, has made a significant impact on improving the health of the region.
In 2003, Siteman and Washington University School of Medicine in St. Louis launched the Program for the Elimination of Cancer Disparities (PECaD). This program serves as a national model for eliminating local and regional disparities through cancer education, prevention and treatment. Led by Graham Colditz, MD, DrPH, the Niess-Gain Professor of Surgery and chief of the Division of Public Health Sciences, PECaD has implemented programs in north St. Louis, as well as the Bootheel and the Mississippi Valley regions in southeastern Missouri. These regions are among the highest in cancer mortality in the United States.
Simultaneously, over 20 years ago, Washington University cardiothoracic surgeons brought leading heart and lung care to Christian Hospital. Since that time, the Department of Surgery has continued to invest in north St. Louis County. Today, Washington University surgeons from each specialty—including acute and critical care, breast surgery, colon and rectal surgery, plastic and reconstructive surgery, vascular surgery, and urology—provide the highest quality of care to patients in the historically underserved north county area. These specialty surgeons, have helped with outreach, placing patients on innovative clinical trials, and participation in health fairs, and community events.
Additionally, Siteman Cancer Center opened a satellite location at Northwest HealthCare, featuring state-of-the-art technology and expert care from Washington University medical and radiation oncologists. Eberlein, who is director of Siteman Cancer Center, notes that the Siteman North County location was developed with close ties to community organizations, ensuring that the programs meet the needs of local patients. The location also features a community room, available for use by local groups and nonprofit organizations, bringing the community and physicians together in lasting partnerships.
Numerous grants from the National Institutes of Health (NIH) support research in the department focused on eliminating cancer disparities and improving healthy equity. A recent $17 million NIH grant, funded through the National Cancer Institute’s Cancer Moonshot program, aims to address disparities in rare and understudied cancers that affect underrepresented groups. The Washington University Participant Engagement and Cancer Genomic Sequencing Center, funded by the Cancer Moonshot program grant, will focus on African American patients with colorectal cancer and multiple myeloma, as well as patients of any race or ethnicity with cholangiocarcinoma. An engagement optimization component of the project seeks to understand patients’ hesitancy around clinical trial participation, which will help investigators design future research studies and engage with potential participants.
All of these efforts by the Department of Surgery has resulted in a 43% reduction of late stage breast cancer in African-American women. Similar programs are actively being replicated in prostate, lung, and colorectal cancer. The Department and Siteman Cancer Center have also established a “network” of institutions in the region who are partnering with them to improve screening of the community, implement smoking cessation programs, improve exercise of patients as well as improve nutrition and improve health equity.
The Department of Surgery at Washington University has long been at the forefront of addressing health care disparities through research and community engagement. Improving the health equity of patient populations is a critical aspect of the department’s mission. It is vital to increase the diversity of surgery as a specialty, Eberlein asserts, in order to better reflect the communities we serve.