Cancer Disparities Progress Report highlights ‘grim reality,’ strides toward equity
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In its 2022 Cancer Disparities Progress Report, American Association for Cancer Research discussed advances made in closing substantial gaps in care while underscoring the need for further progress.
The report is intended to highlight disparities in the delivery of cancer care, make specific recommendations for achieving health equity, and urge the oncology community to redouble its efforts toward overcoming this pervasive and multifactorial problem.
“While I’m indeed honored to present our work, it’s also with a heavy heart that I do so, because disparate cancer outcomes related to socioeconomic resources, race, ethnicity, geography and/or gender orientation represent risk factors for adverse cancer outcomes that really shouldn’t exist in an oncology research and clinical care community,” Lisa A. Newman, MD, MPH, chair of the report’s steering committee and chief of the breast surgery section at New York-Presbyterian and Weill Cornell Medicine in New York, said in a congressional briefing on the report. “As stewards of public health through advocacy and legislative action, we absolutely have the tools to eliminate cancer disparities, and in achieving cancer health equity, we will be that much closer to eradicating cancer as a life-threatening disease. Overall, this progress report provides a roadmap to these goals, which are within our reach.”
The ’grim reality’
The report discussed the complex and intersectional factors known as social determinants of health, which are defined as the “social, economic and physical conditions in the places where people are born and where they live, learn, work, play and age that can affect their health, well-being and quality of life,” according to an AACR press release.
“While research is driving tremendous progress against cancer and other human diseases, the grim reality is that these advances have not benefited everyone equally,” Lisa M. Coussens, PhD, FAACR, associate director for basic research and chair of the cell development and cancer biology department at OSHU Knight Cancer Institute, said during the briefing. “Progress is coming too slowly, especially for racial, ethnic, sexual and gender minorities; individuals from low socioeconomic status; and those who live in rural America. It’s for these reasons that we’re so committed to understanding and addressing the biological and systemic roots of these disparities.”
The report listed the following disparities in cancer care for underserved populations:
- Incidence and mortality rates for multiple myeloma in the Black population are at least double those of the non-Hispanic white (NHW) population.
- The Hispanic population’s mortality rate from liver cancer is nearly twice that of the NHW population.
- The incidence rate of kidney cancer in the American Indian/Alaska Native population is 80% higher than that of the NHW population. This population also has the highest liver cancer incidence among any major U.S. racial or ethnic group.
- Transgender men are more than twice as likely to be diagnosed with cancer compared with cisgender men.
- Residents of low-income areas have a disproportionate rate of cancer deaths — counties considered persistently poor had mortality rates 12.3% higher for all cancer types and more than 40% higher for stomach cancer.
- Individuals residing in rural areas have 17% higher mortality rates from all cancers combined compared with urban communities, with 34% higher death rates from lung cancer and 23% higher death rates from colorectal cancer.
The report called for more inclusive and diversified accrual on clinical trials to ensure that all patient groups are represented and stand to benefit from the treatment being evaluated. It also noted the need for large and inclusive genomic databases to increase knowledge of cancer-related genomic changes that affect cancer incidence, progression and treatment response in patients from different ancestral groups.
Cause for hope
The report also discussed progress that has been made in overcoming barriers to equitable cancer care and narrowing care gaps. Among the strides that have been made are the following:
- Between 2000 and 2019, the disparity in overall cancer mortality rates between Black and white patients has narrowed from 26% to 13%.
- With the expansion of Medicaid under the Affordable Care Act, the disparity between Black and white patients initiating chemotherapy in a timely manner (within a month of cancer diagnosis) has been nearly eliminated, as has the disparity between Hispanic and white women receiving timely mammography screening.
- Cancer screening programs that utilize culturally tailored approaches and reduce structural barriers have shown success in improving screening rates among underserved populations, increasing the likelihood of early detection and successful treatment outcomes.
- AACR’s international cancer registry, Project GENIE, has compiled real-world data from more than 121,000 patients — 13.4% from racial and ethnic minority groups.
- NIH’s All of Us Research Program, which is designed to build one of the most diverse databases in history, has enrolled 100,000 people to date — 50% from underserved populations.
- NIH and NCI have introduced several initiatives to support underrepresented minority scientists in the research workforce.
Newman discussed the importance of encouraging a diverse oncology workforce as a means of promoting inclusivity, representation and quality in all cancer treatment centers.
“We need to support a pipeline program that will tap into the brilliance and creativity of our diverse young people to strengthen the oncology workforce and support ‘safety net’ hospitals, which were disproportionately devastated by the cost of COVID care,” she said. “These institutions deserve financial support to deliver optimal multidisciplinary cancer care.”
References:
AACR releases Cancer Disparities Progress Report (press release). Available at: www.aacr.org/about-the-aacr/newsroom/news-releases/aacr-releases-cancer-disparities-progress-report/. Published June 8, 2022. Accessed June 8, 2022.
American Association for Cancer Research. 2022 Cancer Disparities Progress Report. Available at: https://cancerprogressreport.aacr.org/disparities/. Published June 8, 2022. Accessed June 8, 2022.
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American Association for Cancer Research. 2022 Cancer Disparities Progress Report. Available at: https://cancerprogressreport.aacr.org/disparities/. Published June 8, 2022. Accessed June 8, 2022.
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