Spotlight on Community Outreach and Engagement: Dr. Erica T. Warner on Understanding Breast Cancer Disparities

Erica T. Warner, ScD, MPH, is an Assistant Professor of Medicine, Harvard Medical School, Assistant Investigator, Massachusetts General Hospital, and Deputy Associate Director of Membership, DF/HCC, with a primary research focus on breast, lung, and colorectal cancers. In this Community Outreach and Engagement spotlight, Dr. Warner answers three questions about her research on racial, ethnic and socioeconomic health disparities, and emphasizes the importance of community engagement in advancing health equity.  

Three Questions for Erica 

 

1. Can you tell us a little about your role and background?
   
   I am a cancer epidemiologist with a focus on breast, lung, and colorectal cancers, though I do work that includes other cancer types. My research investigates topics across the cancer care continuum from trying to understand and identify risk factors for cancer, to evaluating new approaches for early detection, to identifying and implementing strategies for improving cancer survivorship. Throughout all my work, I emphasize understanding racial, ethnic, and socioeconomic health disparities and advancing health equity.  
   
    

2. How has your research advanced our understanding of breast cancer disparities across the cancer control continuum? What interventions have you found to be effective at addressing breast cancer disparities and promoting health equity?  
   
   My work has tried to determine factors that lead to differences in risk of breast cancer and breast cancer survival between Black and White women. We’ve shown that reproductive factors like number of births and breastfeeding contribute to differences in risk of one type of breast cancer, known as hormone receptor positive. We’ve also shown that Black women are more likely to die from breast cancer than White women and that this finding is true across all subtypes of breast cancer. Later stage at diagnosis among Black women is an important contributor to survival disparities, but does not fully explain the differences, nor does mammography utilization or delays in diagnosis fully explain differences in stage. Among Black breast cancer survivors, we have shown that there are extensive needs for long-term symptom management, psychosocial and spiritual support, and culturally tailored messaging around lifestyle approaches to reduce risk of recurrence (e.g. diet, exercise, etc.). 
   
   Our work suggests that policy changes that address the impacts of systemic racism on access and receipt of high-quality care will allow more Black mothers to breastfeed their babies. In addition, the development of effective targeted therapies for hormone receptor negative tumors (which are most common in Black women) and the implementation of interventions like patient navigation and health system strategies that improve timely receipt of treatment and support patients through completion of therapy and post-treatment, would be beneficial. 
   
    

3. In what ways have you engaged the community in your research, and how has this engagement strengthened your work?  
   
   
   I do a lot of community events through the DF/HCC and work with similar organizations in my research efforts, and I also volunteer with multiple community-based organizations in my personal time. Almost every project starts with hearing from the community to understand needs and craft relevant research questions. Ultimately what I want is to do work that is impactful—not just within our academic walls, but for real people, and I don’t think it is possible to achieve without community engagement.