Seeking solutions to make breast cancer care equitable

Disparities in cancer care may impact patients’ treatment and outcomes, though these factors are frequently overlooked in clinical research. One graduate student at the University of Chicago is hoping to bring attention to breast cancer disparities and improve cancer care through his research.

Jincong “Jason” Freeman, MPH, MS, applies his previous training in social work and public health to study healthcare disparities in breast cancer patients as a PhD student in the Department of Public Health Sciences at the University of Chicago. He is also part of the Health Equity Training Program at the University of Chicago Medicine Comprehensive Cancer Center.

The disparities in breast cancer care he studies are particularly relevant to patients and physicians at the University of Chicago Medicine, as the rates of breast cancer mortality on the South Side of Chicago are among the nation’s highest. Additionally, Black women are 42% more likely to die of breast cancer than white women.

Health equity, as described by the Cancer Center’s Office of Community Engagement and Cancer Health Equity (OCECHE), seeks to eliminate disparities in health risks and outcomes caused by social determinants of health (any non-medical factors that can influence a person’s health outcomes, such as access to nutritious food and reliable housing).

“Social determinants are a really important factor in cancer, or any disease, so I always try to bring a lot of them into consideration in my research,” Freeman explained. 

For one of his research projects, he set out to study the use of palliative care over time among breast cancer patients.

Although palliative care is frequently misunderstood as being limited to hospice care or end-of-life care, it has a broader focus: the management of pain and other symptoms of serious or chronic illnesses, like breast cancer.

Palliative care is a really effective way to help address the side effects and symptoms.

“Breast cancer patients experience a lot of side effects, not just from cancer, but also from cancer treatment," said Freeman. "Many effective cancer treatments, such as radiation, result in undesirable side effects like pain, nausea and sleep problems. Palliative care is a really effective way to help address the side effects and symptoms."

To track trends in palliative care usage, Freeman used the National Cancer Database, a clinical oncology database sourced from hospital registry data collected in more than 1,500 facilities. While he observed an increase in the use of palliative care over the past 5 years, nearly 70% of patients still do not receive this treatment.

Additionally, the disparities in the use of palliative care have persisted over time. 

“There is a gap in terms of accessing palliative care, particularly for racial and ethnic minorities, among breast cancer patients,” he said.

Freeman’s goal is to “educate breast cancer patients, but also providers,” and to “promote palliative care services to improve their quality of life.” 

He said he hopes his work can change the way palliative care is leveraged in the clinical treatment of breast cancer.

Freeman’s work is making a national impact at multiple large oncology conferences. He received two Scholar in Training Awards from the American Association for Cancer Research (AACR) to attend and present at the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved and the 2023 San Antonio Breast Cancer Symposium.

He also received the Conquer Cancer® Merit Award from the American Society of Clinical Oncology Quality Care Symposium and a Professional Development Grant Award from the University of Chicago Medicine Comprehensive Cancer Center. He recently presented at the American Public Health Association's 2023 Annual Meeting.

Freeman’s advisor, Dezheng Huo, PhD, Professor of Medicine and Public Health Sciences, said these awards did not come as a surprise, as Freeman’s diligence has allowed him to tackle many projects at a time.

He added that Freeman is an independent thinker driven by his passion for the work.

“He really wants to solve the problems, find the problems and give solutions. He’s very devoted,” Huo said.

Freeman is continuing his work on population-level healthcare disparities at the Center for Health and the Social Sciences (CHeSS) at the University of Chicago, where he is a predoctoral fellow with

The National Institute of Aging (NIA) T32 Program in the Demography and Economics of Aging.

Note: The Health Equity Training Program at the University of Chicago Medicine Comprehensive Cancer Center is funded by the Susan G. Komen® Breast Cancer Foundation.