Patrick A. Williams|Sayyed K. Zaidi|Rajarshi Sengupta
<i>AACR Cancer Disparities Progress Report 2022</i>
American Association For Cancer Research|American Association For Cancer Research|American Association For Cancer Research
advances cancer prevention early detection coupled breakthroughs treatments led steady decline overall us cancer mortality rates increase number people living longer fuller lives cancer diagnosis however evident large segments us population benefitted equally advances continue higher rates cancer incidence diagnosed aggressive cancer suffer worse outcomes american association cancer research aacr cancer disparities progress report 2022 httpswwwaacrorgcdpr2022 outlines recent progress cancer health disparities ongoing challenges faced racial ethnic minorities medically underserved populations emphasizes vital need advances cancer research patient care benefit populations commentary summarizes highlights reportracial ethnic minorities medically underserved populations united states continue share disproportionate burden cancer compared white population american indianalaskan native population experiences higher incidence rates lung colorectal kidney cancers well liver stomach cervical cancers caused infectious agents population also higher mortality kidney liver cancers compared white population asian population encompasses highly diverse group countries cultures ethnicities likely impacted cancers caused infectious agents black african american individuals constitute third largest racial ethnic population united states compared white men cancer incidence black men 6 higher cancer mortality 19 higher black women 8 lower cancer incidence white women 12 higher cancer mortality hispanic population one fastest growing ethnic groups united states higher incidence mortality liver stomach cervical cancers compared nonhispanic white population compared nonhispanic whites native hawaiian pacific islander groups higher incidence breast multiple myeloma lung cancers higher mortality prostate lung breast liver intrahepatic bile duct cancers groups experience disparities cancer burden include rural populations individuals belong sexual gender minority populations low socioeconomic status living persistent povertythe causes cancer health disparities stem adverse social determinants health sdoh complex interrelated overlapping factors operate individual community societal levels sdoh include socioeconomic factors modifiable cancer risk factors psychologic factors environmental factors health care access experiences well biological genetic factors increasingly evident structural racism systemic injustices key contributors adverse sdoh creating conditions perpetuate health inequities including cancer health disparities racial ethnic minorities medically underserved populationsroutine cancer screening one effective ways reduce burden cancer population level yet many disparities cancer screening exist racial ethnic minority groups medically underserved populations disparities stem mistrust health care system caused historical exploitation certain populations cultural beliefs stigmas around getting screened well suboptimal screening guidelines developed based studies performed white cisgendered participants research indicated effective ways increase knowledge screening reduce stigma comprise culturally appropriate communitycentered public health interventions evidence also accruing reducing structural financial barriers cancer screening effective approach increase access servicesuse anticancer treatments surgery radiotherapy chemotherapy molecularly targeted therapy immunotherapyalone combinationshas become standard care patients cancer despite major advances treatments recent years racial ethnic minority groups medically underserved populations frequently experience severe multilevel barriers access quality cancer treatment including delays lack access standardofcare treatments ninetythree percent respondents survey 165 cancer physicians practicing community hospitalbased settings agreed sdoh negatively impacted patients health outcomes many patients disadvantaged population groups also experience overt discrimination andor implicit bias receipt care influenced many factors including physician training one solution increase diversity healthcare workforce fewer black adults 22 report providers race compared white adults 74 among hispaniclatino adults 23 report provider race andor ethnicity language preference increasing diversity healthcare workers increase patientprovider trust communicationdevelopment new anticancer treatments cancer detection methods relies testing clinical trials ensure safety efficacy therefore imperative clinical trial participant population highly diverse also important equal representation subgroup ie oversampling nonmajority populations produce statistically powerful estimates effect maximize impact across groups unfortunately enrollment cancer clinical trials extremely low serious lack sociodemographic diversity among participate many individuallevel barriers patients prevent participation clinical trials include lack awareness clinical trials limited health literacy mistrust health care system well financial barriers costs cancer treatment medication transportation childcare lost work inadequate complete lack insurance among othersencouragingly recent data show racial ethnic disparities cancer outcomes eliminated every patient equitable access standard care treatments fact researchers shown racial ethnic minority patients respond better treatments many cancers compared white patients better outcomes offered similar access standard quality care therefore imperative sectors work together address challenges disparities cancer treatment necessity achieve health equity regard noted several clinical studies including accountability cancer undoing racism equity accure program shown multilevel interventions utilize patient navigation address current disparities cancer treatment improve outcomes patientsas genetic sequencing tumors becoming cheaper accessible use helped accelerate pace progress precision medicine genetic sequencing also helped identify risk loci genes brca12 increase predisposition individual developing certain types cancer unfortunately lack representation racial ethnic minority underrepresented groups studies examining mutations risk loci severely limited understanding genetic predispositions lead higher incidence mortality increased aggressiveness cancer certain populations instance cancer genome atlas tcga started 2006 joint effort nci national human genome research institute nhgri characterized 20000 primary cancer matched normal samples 77 percent individuals primarily european ancestry despite population making 578 percent us population furthermore data available tcga database germline somatic exomes patients primarily african ancestry found lower sequencing depth greater number genomic regions insufficient coverage somewhat attributed predominantly european biased reference genome continue increase understanding cancer risk pathogenesis treatment options groups researchers must increase diversity datasets regard us research program building diverse health database includes biological environmental lifestyle information 1 million people united states march 2022 project sequenced entire genomes 100000 people 50 selfreported part racial ethnic group historically underrepresented researchas people living longer fuller lives cancer diagnosis greater attention needed toward understanding survivorship experience every cancer survivor unique experience belonging medically underserved populations experience increased long lateterm side effects reduced healthrelated quality life insufficient palliative care including intense unnecessary endoflife interventions higher rates financial toxicity medical debt reduced adherence followup care key charting equitable path forward cancer survivors use communitybased culturallytailored solutions involvement patient advocates navigators address specific social psychologic medical physical needs patientsystemic inequities social injustices adversely impacted every aspect cancer research patient care including limited participation clinical trials differences cancer incidence outcomes among underserved populations low access quality cancer care worsened survivorship experience new research initiatives closing gaps progress slow cost cancer health disparities remains monumental report concludes action items call upon policy makers stakeholders join forces eliminating menace cancer health disparities calltoaction items include increasing funding nih overall particular nci national institute minority health health disparities centers disease control prevention collecting disaggregated patient data racial ethnic minorities well sexual gender minorities removing barriers improve clinical trial diversity increasing cancer screening access prevention efforts making health care accessible comprehensive improving workforce diversity levels cancer research care enacting health equity accountability act provisions fulfilling recommendations included aacr call action demands ongoing active participation broad spectrum stakeholders efforts must coupled actions eradicate systemic inequities social injustices significant barriers health equityno disclosures reported