Dr. Olawaiye on the Social and Biological Determinants of Disparities in Women’s Cancer

Alexander B. Olawaiye, MD, director, Gynecologic Oncology Research Program, professor, Gynecologic Oncology, Department of Obstetrics, Gynecology & Reproductive Sciences, Magee-Women’s Hospital, the University of Pittsburgh Medical Center (UPMC) Hillman Cancer Center, discusses the social and biological determinants of disparities in women’s cancer.

Institutional racism, conscious and unconscious bias, and lack of patient trust in institutions can all factor into the social determinants of disparities in cancer, Olawaiye says. However, not all disparities can be accounted for by social determinants, Olawaiye adds. For example, when Black women are diagnosed with endometrial cancer, they typically present with higher grade, more dangerous cancer histology types, Olawaiye explains.

Risks are higher for patients who are diagnosed with a more serious form of disease, compared with someone who is diagnosed with a low-grade endometrial cancer, which can be cured by surgery alone, Olawaiye continues. The patients with higher grade cancer are more likely to suffer an early recurrence, and these patients tend to be diagnosed at advanced stages, which is ultimately more likely to kill the patient, Olawaiye says.

While some social determinants impact disparities in cancer, it must also be recognized that biological factors also play a role, Olawaiye says.