Demetria Smith-Graziani, MD
Hematology and Medical Oncology Fellow
The University of Texas MD Anderson Cancer Center
Conquer Cancer, The ASCO Foundation
Studying the association between discrimination, trust, and pain outcomes following surgery among Black women with early-stage breast cancer.
Black patients often experience more severe acute and chronic pain than white patients do, and this disparity is due in part to differences in the perception, assessment, communication, and management of pain. In a previous study, Dr. Smith-Graziani found that this extended to women with breast cancer undergoing breast surgery—Black women reported higher pain severity and interference with life compared to white women. While other studies have attempted to improve racial inequities in pain outcomes, these disparities persist, likely because multiple factors contribute to pain expression and adequate pain management. With her Conquer Cancer Young Investigator Award, supported by BCRF, Dr. Smith-Graziani and her team will explore this complexity by assessing if Black breast cancer patients who experience perceived discrimination from physicians—and consequently mistrust their medical providers—experience different pain outcomes.
Dr. Smith-Graziani’s team will measure perceived provider discrimination among Black women with early-stage breast cancer within one year after mastectomy and determine the association with pain. They will also assess the role of trust in a medical provider, as mistrust may result from perceived discrimination and could also perpetuate disparities in pain severity. Participating patients will fill out three surveys measuring their perceived discrimination from healthcare providers, how much patients trust their doctors, and their pain intensity and its effect on daily life. If Dr. Smith-Graziani does find a connection between pain and perceived discrimination or mistrust, then future interventions could create lasting changes in pain management.
Demetria Smith-Graziani, MD is a third year Hematology and Medical Oncology fellow at University of Texas MD Anderson Cancer Center. She graduated from Tufts University School of Medicine in 2015 and completed her residency in Internal Medicine at Emory University School of Medicine in 2018. Dr. Smith-Graziani is also pursuing a Master of Public Health in Epidemiology at UTHealth School of Public Health.
Throughout her medical training, Dr. Smith-Graziani has provided care for underserved patients, and she is passionate about utilizing the resources of major academic centers to improve cancer outcomes for the most vulnerable populations. She will use the funds from her Conquer Cancer Young Investigator Award to conduct a cross-sectional study of the association between perceived discrimination, trust in provider, and pain outcomes among Black women with early-stage breast cancer after mastectomy. After fellowship, Dr. Smith-Graziani will be an academic breast medical oncologist at Baylor College of Medicine focusing on health equity research. She aspires to develop multilevel interventions to eliminate disparities in breast cancer outcomes.
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