Dr. Rachel Issaka receives the Kathryn Surace-Smith Endowed Chair in Health Equity Research

Flexible funding will further physician-scientist’s work in colorectal cancer and health inequities
A photo of Dr. Rachel Issaka
Fred Hutch clinical researcher Dr. Rachel Issaka is the inaugural recipient of the Kathryn Surace-Smith Endowed Chair in Health Equity Research. Fred Hutch file photo

Fred Hutchinson Cancer Research Center clinical researcher Dr. Rachel Issaka was just named the inaugural recipient of the Kathryn Surace-Smith Endowed Chair in Health Equity Research.

The new endowed chair will help advance Issaka’s research, which focuses on reducing colorectal cancer deaths and disparities, particularly among members of racial/ethnic minority groups and low-income populations, through increased screening and follow-up of non-invasive screening tests.

“It is an honor to receive this endowed chair in health equity research,” said the gastroenterologist and clinical researcher. “I’m grateful for Kathy Surace-Smith, Brad Smith and Fred Hutch’s investment in my research program and health equity at large. My inspiration and resolve to address health disparities in colorectal cancer and other diseases is renewed.”

Issaka, who joined the faculty of the Hutch, Seattle Cancer Care Alliance and the University of Washington in 2017 from the University of California, San Francisco, said the flexible funding that an endowed chair provides is especially meaningful for early-career researchers, who often face a funding gap between career development awards and large National Institutes of Health research project grants or equivalent awards.

This gap can be so challenging that many clinician-scientists stop doing research altogether and return to doing clinical work, she said.

“Having resources that can be used as needed, for example, to support salaries or to fund high-risk pilot projects, is invaluable when building a research program,” she said. “It also speaks volumes about the institution’s commitment.”   

Issaka said she will use the funds to cover salaries first, then will explore expanding innovative interventions, including those that address logistical barriers to screening as revealed by her research.

Hutch Director and President Dr. Thomas J. Lynch, holder of the Raisbeck Endowed Chair, said he was ecstatic about the news.

“Dr. Issaka has shown incredible dedication, rigor and agility with regard to her colorectal cancer research, especially during this pandemic,” Lynch said. “We are thrilled to have our first Hutch endowed chair in health equity, and are beyond thrilled to have our board chair, Kathryn Surace-Smith, recognize and respond so generously to this critical area of research.”

Structural barriers, to health and to funding

As a researcher and clinician, Issaka is particularly interested in understanding the issues that cause delays in cancer diagnosis and treatment. Colorectal cancer, when detected and treated early, is often curable; the five-year survival rate for localized colorectal cancer is 90%.

But not everyone is able to benefit from early screening programs — or from treatment.

Currently, 40 out of every 100,000 white people are diagnosed with colorectal cancer and 16 of those people die. Among African Americans, the incidence rate is 49 out of 100,000 and 21 of those people die. Among Alaska Natives, the incidence rate is 91 per 100,000 and 38 of those patients end up dying (a rate more than twice that of whites). While Hispanics have a lower rate overall, they’re often diagnosed at a younger age than non-Hispanics, as are many Black and Indigenous people. 

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“There are a several social determinants that influence whether a person will complete their screening — or their treatment — for colorectal cancer,” Issaka said. “It has to do with where they live, whether they have insurance, whether they have access to preventive cancer care, to treatment once diagnosed, and the list goes on. There can be many systemic barriers to care.”

Systemic barriers even impact whether this type of research is funded or not, she added.

“A 2019 analysis found that 20% of the funding gap between Black and white researchers could be explained by their area of scholarship,” Issaka said. “Black scientists are more likely to conduct community or population-based research and health disparities research, both topics that are systematically underfunded by the NIH. The COVID-19 pandemic reminded us of how important these topics are, not only in cancer research, but to our society’s well-being.”

Issaka hopes to change this disparity — and the overall colorectal health of the U.S. population — by conducting rigorous research about prevention and testing innovative interventions that reduce the burden of colorectal cancer.

“I believe lessons learned from colorectal cancer prevention can be applied to other preventable diseases,” she said.

COVID-19 puts health disparities into sharp relief

When COVID-19 first hit and began to cause delays in regular cancer screenings, Issaka realized the pandemic “could undo progress in the management of chronic diseases.”

So she quickly began addressing the importance of cancer prevention in articles and through social media, even creating a PSA to raise awareness about the high mortality rates of colorectal cancer in African Americans.

“In the midst of a pandemic, we cannot and should not abandon chronic disease management or disease prevention,” she wrote in Scientific American.

She also championed “safe screening” through the use of an at-home colorectal cancer screening tool known as a FIT kit (short for fecal immunochemical tests), writing in a JAMA Health Forum article that while it was not a perfect intervention, “it has the advantages of enabling effective screening in remote health care settings at a low cost, making it very useful during times of mandated social distancing.”

“Screening is a way to not only prevent disease but reduce racial and economic disparities,” she said. “We need to close that gap so that every citizen can benefit from the advances in cancer care and prevention.”

Health equity has been the focus of a number of Issaka’s studies and papers, including new research on the effectiveness of FIT kits for colorectal cancer screening during COVID-19; an essay about structural racism in health care and a study that identified barriers to colonoscopy completion after an abnormal FIT in a safety-net population.

Photo of Kathy Surace-Smith

'It wasn’t this study or that paper that convinced me to do this. It was the whole package, the whole thrust of her career. It was her focus and her passion that really inspired us.'

— Kathryn Surace-Smith, Fred Hutch board of trustees chair


Guts and passion

More recently, Issaka has appeared in several Fred Hutch virtual Town Halls and other events; she even spent time bantering with The Daily Show host Trevor Noah at a Fred Hutch Science Says virtual event in November.  

While the back and forth with Noah wasn’t the first time Surace-Smith saw Issaka in action, the researcher’s passion definitely impressed the chair of the Hutch board of trustees and confirmed her decision to support Issaka’s research with an endowed chair.

“I didn’t know Rachel, but I’ve seen her in the Town Halls and I’ve looked at the work she’s doing and it’s groundbreaking,” Surace-Smith said. “I also loved the way she talked about her research with Trevor Noah, even turning the tables on him and asking him to tell his famous friends to get screened. That took guts.”

The senior vice president and general counsel of NanoString Technologies, Surace-Smith has served on the Hutch board since 2014. She was named board chair in 2020.

Surace-Smith said she and her husband, Microsoft President and Vice Chair Brad Smith, had been talking for many years about funding a Hutch endowed chair that focused on health equity. During the Hutch’s recent challenge campaign to create more endowed chairs, they made a formal commitment, then worked with Lynch to find a researcher whose work they wanted to exclusively support. Issaka was the perfect candidate.

“I’ve seen a lot of the research being done on this at the Hutch and became really interested in why certain populations suffer from a higher rate of cancer or have a lower survival rate than others,” she said. “Then COVID hit and we saw the disparities play out in real time and real life. It just brought it into sharp relief.”

Surace-Smith said she and her husband wanted to see more work being done on this “because it’s not just cancer, it’s a lot of public health issues. And it’s very important to address.”

She also appreciated Issaka’s singular focus on this field of research.

“It wasn’t this study or that paper that convinced me to do this,” she said. “It was the whole package, the whole thrust of her career. It was her focus and her passion that really inspired us.”

The Fred Hutch board of trustees initiative to match donor gifts to create endowed faculty chairs concluded in 2020. Fred Hutch currently has 36 endowed chairs, which allow donors to partner with scientists and invest in high-risk, high-reward research.

Diane Mapes is a staff writer at Fred Hutchinson Cancer Center. She has written extensively about health issues for NBC News, TODAY, CNN, MSN, Seattle Magazine and other publications. A breast cancer survivor, she blogs at doublewhammied.com and tweets @double_whammied. Email her at dmapes@fredhutch.org. Just diagnosed and need information and resources? Visit our Patient Care page.

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