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VCU Massey Cancer Center was one of 10 national awardees selected to receive a grant from the American Cancer Society and Pfizer to address systemic race-related barriers and disparities in the delivery of care that impact outcomes across all cancer types.

The grants, funded by Pfizer Global Medical Grants and overseen by the American Cancer Society, are part of the Addressing Racial Disparities in Cancer Care Competitive Grant Program, a three-year collaboration working to promote equity in factors that impact cancer outcomes for Black men and women. The collective grants total more than $3.7 million in 10 communities focused on reducing racial disparities in care and helping optimize cancer outcomes for Black men and women. Grant funding begins in January 2021.

At Massey, the grant supports the COALESCE (Clinics & COmmunities TAckling RaciaL DisparitiEs, Systemic in (Colon and Cervical) Cancer ScrEening) project led by Katherine Tossas, Ph.D., M.S., director of catchment area data access and alignment, Harrison Endowed Scholar in Cancer Research and Cancer Prevention and Control research member at Massey Cancer Center. This two-year award of $400,000 will assist Massey in serving as the cancer center for Virginia supporting a network of 10 community partners throughout the state to jointly identify and address systemic, race-related barriers to colon and cervical cancer screening and diagnostic follow-up care in those communities. The goals of the project are to increase screenings by 5-10%, improve diagnostic follow-up processes, increase provider and community cancer screening knowledge and build longitudinal partnerships that support cancer health equity initiatives beyond the term of this project.

Cancer is a disease that affects everyone, but it doesn’t affect everyone equally. Black patients experience more illness, worse outcomes and premature death compared to white patients in the United States. Further, Black people have the highest death rate and shortest survival of any racial/ethnic group in the United States for most cancers. Black men also have the highest cancer incidence.

Robert Winn, M.D., director of VCU Massey Cancer Center, meets with the Brunswick Health Ambassadors, a partner community organization in Lawrenceville working with local FQHC Central Virginia Health Services on the COALESCE project.

With 56% of colorectal cancers diagnosed at later stages, Virginia remains one of three enduring colorectal mortality hotspots in the U.S. The same goes for cervical cancers, with 48% diagnosed at later stages. Mortality for these preventable cancers is worse for Black Virginians relative to white Virginians. Mortality can be averted with equitable access to screening and timely diagnostic follow-up, but systemic barriers such as fractured referral systems and extended time between medical visits remain. The confluence of racism and discrimination fueling medical mistrust among Blacks, current heightened racial unrest and the COVID-19 pandemic, make for the perfect storm to exacerbate existing racial disparities in cancer outcomes.

Black Virginians concentrate in the south-central and eastern portions of the state, as do poverty and lack of insurance. Because Federally Qualified Health Centers (FQHCs) care for underserved communities regardless of their ability to pay, they are ideal partners to tackle systemic barriers to cancer screenings. Therefore, Massey’s COALESCE project will implement a quality improvement initiative at five FQHCs in Brunswick, Danville, Martinsville and Richmond to identify systemic barriers and address race-related barriers to colorectal and cervical cancer screening and diagnostic follow-up using evidence-based approaches. The FQHCs will do this work in partnership with local community organizations to elevate the community’s voice, increase community support, acceptance, uptake and sustainability of the implemented intervention.

This board displayed inside Massey's Cancer Research and Resource Center in Lawrenceville reflects community input as to what is good health in Brunswick County

 “We are thrilled to receive this award and humbled by the trust and enthusiastic participation of the partnering federally qualified health centers and community organizations,” said Tossas, who is also an assistant professor in the Department of Health Behavior and Policy and affiliate assistant professor in the Epidemiology Division of the Department of Family Medicine and Population Health at the VCU School of Medicine. “Federally qualified health centers are at the helm in the quest for health equity, providing primary health care for all, regardless of their ability to pay. Community organizations are dedicated and enduring advocates for their neighborhoods. Partnering with them to identify and boldly address systemic, race-related barriers to colon and cervical cancer screening and diagnostic follow-up care was a clear choice.”

Tossas added: “Together, Massey and our community partners will hold each other accountable, ensure the community’s intelligence is represented and break from the common consciousness that might have contributed to the problem of inequitable access to cancer care to co-create improved, sustainable solutions. As the cancer center FOR Virginia, we are natural allies in the quest to halt cancer, speak truth to power and bend the arc towards cancer health equity.”

Written by: Jenny Owen