Fred Hutch/UW study provides insights into changing global medical landscape
Korean Americans who have traveled to other countries for low-cost medical care are nearly nine times more likely to be up-to-date with colorectal cancer screening compared to those who did not engage in medical tourism, according to new research from Fred Hutch and the University of Washington School of Public Health.
Researchers found that Korean-American patients who travel to South Korea for care tend to be without health insurance and less likely to speak English well. Also, they may not have a usual place of care and may have immigrated to the U.S. at an older age.
“Health care providers in the U.S. need to be aware that immigrant populations may be engaging in medical tourism and receiving cancer screening outside of the U.S.,” said lead author Dr. Linda Ko, an assistant member of the Public Health Sciences Division and director of the Health Communication Research Center in the Cancer Prevention Program at Fred Hutch and an assistant professor of health services at UW. “Health care providers also need to be aware that people who engage in medical tourism may be following a set of cancer-screening guidelines different from the U.S., making communication with these patients critical to avoid mistrust with the U.S. medical system.”
Ko and her research team conducted a community-based, cross-sectional study in 2013 over a three-month period, from August to October. Data was collected on 193 Korean-American patients, ages 50-75, residing in the Seattle area. Participants completed an in-person, self-administered survey.
The findings, published last December in the open-access journal BMC Cancer, showed that one-third of the participants surveyed reported traveling to South Korea for medical care. Those who engaged in medical tourism had 8.91 greater odds of being up-to-date with colorectal cancer screening compared to those who did not travel for health care. Medical tourism, therefore, emerged as the strongest predictor of colorectal cancer screening.
“Health care providers may want to take the time to assess medical tourism, especially when screening tests show positive results and treatment with the U.S. oncologist becomes critical,” Ko said.
Colorectal cancer remains the most commonly diagnosed cancer among Korean Americans in part due to low screening rates, according to the study. “Prevention and early detection of colorectal cancer through the use of screening tests have resulted in better prognosis and longer survival and reduced disease incidence and mortality,” the researchers wrote.
“Public health professionals may want to discuss with those engaging in medical tourism about the importance of timely care and the negative consequences of delayed care with medical tourism, as well as finding a health care provider in the U.S. to receive continuous cancer care in the U.S. if screening tests show positive results,” Ko said.
The Centers for Disease Control and Prevention, National Cancer Institute, and Fred Hutchinson Cancer Research Center Development Funds supported this work.
Fred Hutch colleagues Dr. Victoria Taylor, Jihye Yoon, and Wade Copeland also contributed to the study, as did UW Medicine gastroenterologists Dr. John Inadomi and Dr. Joo Ha Hwang. Dr. Eun Jeong Lee was a key contributing community partner from the National Asian Pacific Center on Aging.
— Adapted from a University of Washington School of Public Health news release
Dr. Jarrod Dudakov wins 2nd ASH Scholar Award
The American Society of Hematology has named Dr. Jerrod Dudakov, a researcher in the Fred Hutch Program in Immunology, among 27 recipients of its 2017 Scholar Awards, one of the organization’s most prestigious award programs.
Specifically, Dudakov has received the ASH Scholar Award for Basic Junior Faculty, one of 12 such recipients nationwide. Along with the honor he will receive $150,000 over a two- to three-year period to continue his research into understanding the role of the thymus organ in immune-cell regeneration.
The thymus — a butterfly-shaped organ that sits in the front part of the chest behind the sternum and between the lungs — is the primary site of immune T-cell development. According to Dudakov, it is critical to our bodies’ ability to fight diseases, including cancers. Although generally able to repair itself, the thymus is extremely sensitive to damage and its function declines profoundly with age. This breakdown in function likely contributes to many disease states and also reduces the ability of a patient’s immune system to fight disease.
The Dudakov Lab, based in the Clinical Research Division, is working to understand endogenous thymic regeneration in molecular detail so that therapies might be developed, as needed, to enhance T-cell immunity.
With funding from the ASH Scholar Award, Dudakov and colleagues are rigorously studying so-called “innate lymphoid cells,” or ILCs, rare cells that are central to natural regeneration of the thymus. Their goal is to identify the ILC-produced factors that are critical in this process, and to learn how exactly these cells promote thymic regeneration. Importantly, they will test the ability of ILC-produced factors, or the ILCs themselves, to be used in treatments to boost T-cell immunity.
Such interventions could be quite valuable for cancer patients who undergo thymus-damaging radiation treatments and/or chemotherapy, including the generally aggressive “conditioning” required before hematopoietic stem cell transplantation. Targeted thymic regeneration could also significantly benefit individuals with T-cell deficiencies caused by aging, autoimmune disease, genetic causes (such as severe combined immunodeficiency), infectious diseases (such as HIV) or radiation injury (such as that caused during a nuclear accident).
The ASH Scholar Awards financially support fellows and junior faculty dedicated to careers in hematology research as they transition from training programs to careers as independent investigators.
This is a rare second ASH Scholar Award for Dudakov, who last year joined the Fred Hutch Clinical Research Division as an assistant member. His first, an ASH Basic/Translational Fellow Award, was in 2013, when he was a senior research scientist in immunology at Memorial Sloan-Kettering Cancer Center.
— Kristen Woodward / Fred Hutch News Service
