Cancer disparities and HPV prevention with Dr. April Wilhelm and Dr. Serena Xiong

February is National Cancer Prevention Month. This month we sat down with Masonic Cancer Center, University of Minnesota health equity researchers Drs. April Wilhelm and Serena Xiong to chat about cancer disparities and HPV prevention. Drs. Wilhelm and Xiong are the special expert guests at our next Fireside Chat, happening February 21! 

Could you give us a brief background on your education, what intrigued you about your field of specialty, and what brought you to the University of Minnesota? 

Dr. Serena Xiong: Like the gymnast, Suni Lee, I am a second-generation Hmong-American. My parents are Hmong refugees who settled in the U.S. in the late 1980s. Before graduate school, I worked as a cancer navigator helping Hmong women to get screened for breast and cervical cancers. In that role, I observed many barriers to cancer screening, barriers that I could not effectively address on my own as an individual service provider, which motivated me to go back to graduate school and pursue a career in cancer prevention research. It was through my graduate school training that I was able to name, codify, and contextualize those barriers and develop a curiosity for understanding how health behavior operates and interacts in various social ecologies (from one’s community to society). By training, I am a behavioral epidemiologist and interventionist—I seek to understand the choices and behaviors of individuals, communities, populations, and health systems, and where we can intervene at each of these levels to promote population health and reduce cancer inequities. Having completed my doctoral training at the University of Minnesota and experiencing first hand its long standing relationship and dedication to advancing health equity, it was only a natural decision to stay at the U to continue my research. 

Dr. April Wilhelm: I am a family medicine physician and completed additional fellowship training in child and adolescent primary care research in the Department of General Pediatrics and Adolescent Health at the University of Minnesota. I also completed my MPH at the UMN School of Public Health with a focus on maternal and child health. I am passionate about reducing health disparities through prevention and treatment interventions that address social determinants of health and other upstream factors that influence individual health behaviors, especially among refugee and immigrant communities in the U.S. I built a lot of great connections in these areas during my fellowship training and was delighted to be able to join the faculty to continue on with this work.

What are the top HPV prevention tips that you have and/or local prevention resources you can share? 

Dr. Xiong: Persistent infection with HPV is a leading cause of various cancers, including cervical, penile, and anal cancers. Fortunately, there are now vaccines available to prevent these types of cancers. HPV vaccines serve as a crucial tool in cancer prevention. In the United States, they are routinely recommended for children aged 11 to 12 years but can be initiated as early as 9 years old. The Centers for Disease Control and Prevention (CDC) has some great and general information on the HPV vaccines and schedule. The Immunization Action Coalition also offers educational resources tailored to the general public.  

Dr. Wilhelm: HPV vaccines are a vital tool for preventing HPV. We can literally prevent most forms of HPV-related cancers with a vaccine, which is so cool! These vaccines are important to complete in children ages 11-15 years because they are much more effective at preventing HPV infection in this age group. Vaccines can be given in primary care clinics but also in school-based health clinics, which are often overlooked for this important service.

Are there services available in the community that could help fill the gaps for people to more easily access screenings and other types of care? 

Dr. Xiong: The Minnesota Department of Health (MDH) provides a plethora of resources for cancer prevention and screening. Through their breast and cervical cancer screening program, SAGE, they offer free screening for breast and cervical cancer, diagnostic services (in case of abnormal screening tests), and referrals to treatment services for low-income individuals or those without sufficient health insurance in Minnesota.There are also MDH-funded programs to support racially and ethnically diverse groups in Minnesota access to cancer screening services. These include:

• The Lao Assistance Center of Minnesota AAPI Women's Coalition
• Southside Community Health Services Breast and Cervical Cancer Screening Project
• The ANIKA Foundation Quality Life MN Campaign
• Breast Cancer Champions Project 

Dr. Wilhelm adds: “SAGE is a crucial program for cervical and breast cancer screening programs for women without insurance in Minnesota. To further help with access, there are a lot of health systems who offer mobile mammogram buses that travel around the metro area to reduce the burden of transportation.” 

How would you describe the importance of representation in medicine and serving diverse communities? 

Dr. Xiong: Representation plays a crucial role in delivering care to diverse communities. As a former healthcare navigator, I served as the linchpin connecting my clients to the care they needed—I functioned as their interpreter, facilitated their transportation access, and, in essence, served as their advocate in a space where they felt underrepresented. To establish equitable care, it is essential to create a safe space for patients, one where they can see themselves represented in the care team.

Dr. Wilhelm: Representation is very important in health care among both clinicians and staff. When patients see clinicians and staff who share their cultural backgrounds and/or languages, communication is often more effective and trust is increased, which can translate to improved health outcomes. The same situation applies to research, and this underscores the importance of community-engaged research. 

What are you doing to advance research in health disparities in your field of specialty? 

Dr. Xiong: I consider myself a storyteller first and a researcher second. In my research, I make a conscious effort to prioritize the inclusion of community voices and narratives in the research process. I firmly believe that when community members contribute to the co-production of their knowledge and solutions, we are taking a closer step toward achieving health equity.

Dr. Wilhelm: I am passionate about using community-engaged research approaches to partner with communities in identifying issues and building culturally-tailored solutions. When community members have a seat at the table, the resulting research products are much more effective and likely to be more sustainable.

Tune in to the Fireside Chat on Tuesday, February 21 to hear more from Drs. Xiong and Wilhelm!