Steven Evans, MD, FACS, is a general surgeon and surgical oncologist with UPMC Hillman Cancer Center. Dr. Evans serves on the Shadyside Hospital Foundation board and is past vice president of the Gateway Medical Society, which represents Allegheny County’s Black physicians. He is an advocate for the elimination of cancer disparities among Black women. Dr. Evans is the co-investigator for the Accountability for Cancer Care through Undoing Racism and Equity (ACCURE) study and founder of Pittsburgh’s first African American cancer caregivers support group. Recently, Dr. Evans was appointed as the director of the Division of Community Engagement in the Division of Surgery at the University of Pittsburgh School of Medicine.
What has been your path to a medical career?
In 1920, Black Americans represented only 2% of medical students in our country. Today, 100 years later, that number has only grown to 6.2%, even though Black Americans represent 13% of our total population in the United States. When I graduated from George Washington Medical School, I was one of just two Black Americans in a class of 155 students.
In my final year of medical school, I had an internship at the National Cancer Institute’s Center for Cancer Research. One of my patients was a Black woman who needed a very serious and rare operation. She saw the long hours we were putting in for her and said to me, “Dr. Evans, I want you to know that I appreciate all you’re doing. Even if this surgery doesn’t give me a longer life, I want to thank you.” I immediately knew then that I wanted to become a surgeon and focus on cancer. Her words ultimately led me to complete a surgical residency at UPMC and a cancer fellowship at the National Cancer Institute.
What kinds of disparities have you experienced as a doctor?
In 1994, shortly after finishing my training, I joined one of the largest private general surgery practices in Pittsburgh. Its leaders were committed to building a diverse medical team of different races, ethnicities, and faiths. Ironically, I shared the same last name as another member of the practice.
Health Disparities Q&A
Some patients would call for an appointment and say, “I don’t want the Black Dr. Evans — I want only the white Dr. Evans.” When the office manager asked me how to handle those requests, I told her she did the right thing by coming to me. I’ve dealt with my racial identity from the day I was born, so who better to help our patients understand and develop a relationship with me — than me? I knew we needed to make it clear to patients that every member of the practice — including me — was equally prepared. We all had the same rigorous training and passed the same surgical boards. That became an important statement of equity that helped everyone realize that the color of my skin had nothing to do with my medical skills.
How would you describe racial disparities in health care today?
Health care disparities should not be looked at as a genetic construct. Socioeconomic access to health care — shaped by factors like being poor or uninsured — are the greater determinants that all come under that umbrella of racial disparities in health care in general and, to a certain degree, in cancer care specifically.
What I’m challenging everyone to do in this conversation about health disparities is to look and listen and become more inquisitive and sensitive about that conversation.
From your vantage point as a surgical oncologist, what challenges do Black women in particular face in terms of health disparities?
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Studies show that Black women die from breast cancer at a higher rate than their white counterparts. Doctors also know colon cancer is the second leading cause of death among Black women, and Black men are at a much higher risk for colon and prostate cancers.
My wife, Cynthia, an African American woman and doctor, succumbed to colon cancer in 2015 when she was just 56 — so I personally understand that cancer has no regard for a person’s socioeconomic status or skin color. That’s why it’s vital for all Black Americans to know that help is available. That’s especially important now, in the midst of this pandemic.
The importance of screenings and early cancer detection is a critical message that we must share over and over again with Pittsburgh’s Black community. In the medical community, we have to advance Pennsylvania as a state where uninsured women can get their mammograms, colonoscopies, and cervical cancer screenings done for free.
How are you personally working to help address these issues?
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I first had to allow myself to be vulnerable enough to speak out on these issues as someone who has personally experienced great losses due to cancer. In addition to losing my wife, my mother died of breast cancer, and my sister was diagnosed with breast cancer in her 50s.
During COVID-19, Zoom and Facebook have given me a much broader platform to communicate with Pittsburgh’s Black community about the risks of cancer. I’ve worked closely with groups like our Black sorority, the Deltas, and with people of influence like Jasiri X (a Pittsburgh activist and rapper) to connect with women of color of all ages on social media.
I’ve also learned professionally that opportunities happen when I ask questions about a problem or gap in resources. When I do, people usually respond, “Why didn’t I see that?” My response is that’s not a sign of insensitivity — you just don’t live in my space. You’re not a Black man. You weren’t a caregiver for a wife struggling with cancer. You weren’t trying to raise three children at the same time. So, when I asked why there wasn’t a cancer caregivers support group for Black Americans in our community, leadership and donors responded with solutions to make it happen.
My form of advocacy is to be that clarion call — to acknowledge that racial disparities exist, but that doesn’t have to be how the story ends. At UPMC, we need to tell the members of Pittsburgh’s Black community that we are here to care for them in an exceptional, first-class way, no matter their race, socioeconomic background, or insurance status.
What can community members do to help?
As individuals and as a medical system, we all have opportunities to grow when it comes to issues like race. Patients and communities of color want to know that we see them — that they are not marginalized just because they are poor or because they are different. If their trust isn’t with us, we cannot move forward in making recommendations about their health.
That kind of trust takes time, but Pittsburgh is a city of bridges. I feel that our greatest asset is the ability to build bridges between communities of color and civic leaders, community leaders, church leaders, and policymakers. We must work together to build a plan that seeks to eliminate racial disparities in health care — and specifically in cancer outcomes. We must all come together with a common goal, pooling our resources so we are not diminishing the power and effectiveness of our voice. If the medical and health-related schools of the University of Pittsburgh work together with UPMC Hillman Cancer Center and all of UPMC, I am confident that we can find a way to strengthen the bonds that are necessary to heal the wounds, bridge the gap, and change how the story ends. To that end, I was just appointed director of the Division of Community Engagement in the Division of Surgery at the University of Pittsburgh School of Medicine. In that new role, I look forward to creating partnerships that will ultimately make a difference.
Do you have hope?
With all that I have gone through, how can I not have hope? It’s the hope that keeps me going! And that’s what I want to pass on to my patients who are suffering from any type of cancer. My goal is to not only to care for them surgically but to provide them with all the support they need to thrive, not just survive. That’s means chemotherapy, radiation, support groups, and more.
Some people are upset by the protests going on now in our society, but protest has been integral to our history. It’s how America became America, starting with the American Revolution. We are no less than the sum of our parts. All of our hues, our colors, and backgrounds make America unique. Martin Luther King, Jr., one of my greatest inspirations, said “Injustice anywhere is a threat to justice everywhere.” So, we must continue to speak truth to justice through our protests and our actions.
You’re known for singing with your patients before surgery. What’s your inspiration for doing so?
I’ve been singing since I was five years old. When I come up with a song, it’s one that’s really intentional — an expression of my spirit at that moment. During these uncertain times, especially when I pray, I sing knowing that we’re not alone on this journey. I call on the song by Kari Jobe, “I Am Not Alone.” I thank God for my privilege of being where I am today. I don’t want to be anywhere that I can’t be all of me — and that’s both a surgeon and a spiritual person. I want to be in a place where I can have the freedom and liberty to be me. And I feel I have found that place.
For more information on health disparities, visit UPMC.com/healthdisparities.