Steve Jones a facilitator from Cancer research UK spoke to Nisa Kahn in the first of a series of podcasts designed to raise awareness of ethnic minority cancer.
What is EMCAM?
EMCAM is a national campaign launched by Cancer Equality to raise awareness of cancer in those of a black or ethnic
minority (BME) background. If BME people know more about cancer signs, symptoms and screening programmes, it can help improve their outcomes. This year, Cancer Equality are supporting #EMCAM with a #stopBlameStopShame hashtag and video.
Why is it important?
Health inequalities are linked to deprivation and poorer access to healthcare. This coupled with cultural barriers and likely lower health literacy makes the reality of cancer for BME groups a worse outcome in some types of cancers.
The Achieving World-Class Cancer Outcomes: Taking the strategy forwards – Equality and Health Inequalities Analysis (National Cancer Programme Team 2016) identified:
- a higher incidence of myeloma and stomach cancer in black people.
- A higher incidence of prostate cancer in black men.
- The incidence of oral cancer is higher in Asian people than in white people.
- Within the Asian population, females are more likely to get oral cancer.
- Cervical cancer rates are higher in Asian women over 65 years of age.
Lord Victor Adebowale chairs the NHS England Empowering People and Communities Taskforce which will partner with communities and the voluntary sector to address the health inequality in cancer by enabling communities to better understand cancer.
A new paper by the Race Equality Foundation (REF) has been published. The Better Health Briefing 47 paper (REF, 2018) identifies 6 key messages, one of which being a poor understanding of the needs of BME communities in cancer support.
In my view, the health system relies on the population to understand what screening programmes are, how to respond to screening appointments, understand what will happen when attending an appointment for screening and know to self-examine between screening appointments.
The onus is on the individual, which if it’s self-reporting or assessing a cold, for example, is appropriate. For cancer, it requires additional support, understanding and education.
Screening programmes recognise the need to proactively request individuals to attend screening by sending letters out. There are many reasons why this can be unsuccessful for the individual invited, such as:
- being overseas visiting relatives,
- not understanding what is being asked,
- not understanding what will happen during a screening visit,
- have a limited understanding of English,
- have no family members that work in healthcare to explain what the letter is about.
Also, the health system doesn’t account for the lived experiences of BME patients. It doesn’t recognise the cultural taboos, the myths or perceived barriers that exist. Examples of myths include believing cancer doesn’t affect them and breastfeeding preventing breast cancer. An example of a cultural taboo is cervical screening in some BME communities.
July is the month to promote cancer awareness in black and ethnic minority groups. All healthcare professionals can have simple conversations with patients they interact with which can allay myths and fears, provide advice and reassure.
I see it as a duty to the richly diverse population we serve in our respective healthcare settings to help empower the patients we encounter in practice. We can do this by helping these patients:
- To become aware of the importance of engaging in screening programmes,
- To learn how to self-examine,
- Have an open and honest conversation with BME patients about the poorer cancer outcomes because cancer signs and symptoms are not identified as early as they can be.
This July you can help to help reduce the health inequalities in cancer by empowering those from BME communities you see in routine practice.
To learn more about signs and symptoms, click on the following link: Be Clear On Cancer Campaign.
Click on the following link for information on the Cancer Patient Experience Survey.
Nisa has personal interest in this topic. She is a BME pharmacist working in an oncology centre. These podcasts were recorded in my role as an RPSGM steering committee member in support of the EMCAM campaign.
National Cancer Programme Team (2016). Achieving World-Class Cancer Outcomes: Taking the strategy forwards – Equality and Health Inequalities Analysis. [pdf] Available at HERE [Accessed 2nd July 2018].
Race Equality Foundation (2018). Better Health Briefing. Cancer and Black and Ethnic Minority Communities. [pdf] Available at HERE [Accessed 3rd July 2018].