Black in Cancer: Championing Diversity in Cancer Research and Medicine

When you hear the titles “cancer researcher” or “oncologist,” there is probably a distinct figure that comes to mind. Black in Cancer was formed so that when you hear those words again, you picture a diverse workforce fighting a common enemy: cancer. Cancer is the second leading cause of death worldwide, which makes it a big issue. A bigger issue, although indirectly related to those outcomes, is the lack of diversity in cancer research and medicine, and we are not talking about patients. Ironically, Black people, specifically African Americans, account for a disproportionate number of cancer diagnoses and deaths in a variety of cancers. However, those same communities do not see their culture well represented behind the scenes or on the front lines of medicine or research, as they are underrepresented (1). As an organization, Black in Cancer aims to change that narrative. An idea that started via social media transformed into a movement that works endlessly to propel diversification in cancer research and medicine. This in combination with the passion of early-career scientists to spark and facilitate needed conversations resulted in ideas for tangible change. Unfortunately, the long-standing trend is to have uncomfortable conversations, take performative action, then forget about it. We are motivated to continue our movement. Our stance on this very important issue will be spoken about for years to come, and we have made the necessary accommodations to foster key initiatives in order to achieve this. The first of many outcomes of these intentional actions was #BlackinCancerWeek. This weeklong event brought together cancer scientists, advocates, and more to amplify and highlight the contributions of Black people in the cancer workforce. Our stories revealed the unspoken issue of the lack of diversity in the cancer field and the increasing issue of cancer disparities in the Black community. Ultimately, the mission of an organization started by Black cancer scientists and their reasoning for championing the push for diversity will serve as the blueprint to transform cancer research, medicine, and advocacy.

Driven by a need for change, the first annual Black in Cancer Week (October 11–17, 2020) began with the intention of connecting people of the same culture in the same field who believed in the same thing: amplifying Black voices in the cancer workforce. The intensity behind this initiative was propelled by the Black cancer community and the support of allies from around the world. Most notably, this movement was brought to fruition by 16 determined early-career scientists, graduate and undergraduate students. Black in Cancer Week was so unique, it stood out from other diversity-focused movements. This week was not focused only on lab-based scientists. We called on every sector in the cancer workforce to join in on this inspirational cause. Starting the week off with #BICrollcall, we highlighted researchers, clinicians, industry professionals, advocates, survivors, and more. Often, Black cancer scientists find our community on social media. Though the isolation at the root of this action is tragic, this has created an opportunity for us to connect and support one another beyond institutional boundaries. However, this does not quell the need for better representation at our home institutions and companies. Later in the week, we shared our personal stories and how they inspire us to continue the fight against cancer, and our expert suggestions on how to recruit and retain cancer research trainees. We ended our week with a dedication to Henrietta Lacks and our promise to continue honoring her in our work. After #BlackinCancerWeek was over, our stories and impact remained. The intersection of experiences from bench-based scientists, epidemiologists, oncologists, and cancer survivors set the tone for many conversations to come. Having the opportunity to engage with a community that you work every day to help makes you a better scientist. Conversely, being able to learn from people on the front lines of discovery about a cancer you are living with gives you hope.

First, it is of utmost importance to increase representation in the cancer field. Cancer is considered a heterogeneous disease, and it is only right that the people who dedicate their lives to fighting this cause be just as diverse. Black people are highly underrepresented in K–12 education, higher education, and the cancer workforce. Exposing underrepresented students, in this case Black students, early and finding ways to effectively retain them through their medical or scientific training is one of the many ways to strengthen diversity and inclusion efforts (2). The Black in Cancer Pipeline Program (BiCPP) was developed to spearhead this endeavor. Through a series of professional development workshops, career talks, and mentor–mentee pairings, this initiative will serve as a gateway for students, trainees, and early-career scientists at every level. There will be student-focused scientific symposiums to strengthen communication and presentation skills, as well as opportunities for postdocs and graduate students to present their work in spaces where they feel supported and welcomed. Given the multifaceted scope of cancer, it is clear that diversification should go beyond the ivory tower. From careers in industry to detailed training in managing cancer-focused nonprofits, the BiCPP will highlight every possible career that is available in the fields of cancer research, medicine, and advocacy. As an organization, we lead by the motto “They can't be what they don't see.” We want students at every level to understand that being a scientist, a physician, or even the CEO of a company is possible. Our way of achieving this is by inviting the brightest minds and strongest voices of color in the cancer field to speak. We believe in the power of representation and exposure and its possible positive effect on cancer disparities, education, and research. Having more Black people in spaces where they are recognized as the minority is power in itself and will have a tremendous impact on cancer-related fields.

Unfortunately, in the United States, Black individuals have greater incidence and/or mortality rates for most common types of cancers (e.g., breast and prostate) compared with other racial groups (3). This holds true for populations in the United Kingdom as well. For example, in both the United States and the United Kingdom, prostate cancer incidence and mortality are higher in non-Hispanic Black men in contrast to other racial and ethnic groups. Additionally, breast cancer is more likely to be diagnosed at later stages and has a greater likelihood of being triple-negative in Black women (ref. 4; http://seer.cancer.gov/statfacts/html/breast.html; http://www.cancer.org/cancer/breastcancer/detailedguide/breast-cancer-risk-factors). Further, Black people and other racial or ethnic minority groups have a long history of receiving inferior quality of medical care. With a plethora of well-documented instances of unethical research conducted on racial and ethnic minority populations and other historically marginalized groups, it is important to understand that the medical field is met with skepticism and mistrust in these communities (5, 6). The Cancer Awareness Project (CAP) was created to bring quality cancer education and accurate information from experts to the Black community. We are approaching this initiative with an understanding of community hesitation but with the realization that information is more likely to be received by people who see themselves represented in healthcare. Specifically, we are delivering this program through Black cancer experts from the clinic, lab, and advocacy sectors. This initiative will consist of monthly seminars that explain the basics of cancer, disparities, cancer prevention, and mistrust in clinical spaces in a format that nonscientists and non–medical professionals can comprehend. Additionally, we will hold discussions with cancer survivors, patients, and advocacy groups to unveil their experiences and advice. These sessions will be easily accessible and paired with visual schematics detailing key information. It is important to note that although this program was developed to equip the Black community with skills in scientific and medical literacy, it is not reserved for this group alone. Anyone who is interested in learning more about cancer is more than welcome to partake. As scientists, we work endlessly to answer the unknown. In the clinic, oncologists work to improve the quality of life for patients with cancer. Having the opportunity to provide information to our communities as Black cancer researchers and clinicians reinforces the importance of our work and provides us with the tools to become better cancer advocates in our own fields.

This is not a complaint; these are the facts. According to the inaugural AACR Cancer Disparities Progress Report 2020, African Americans have had the highest overall cancer death rate of any racial or ethnic group in the United States for more than four decades. How do we mirror these unfortunate numbers in the cancer workforce? Ultimately, we have the conversation. These conversations will be difficult to commence, yet once they happen the growth will begin. There needs to be an intentional effort to hire more Black professors, researchers, and clinicians. We are not asking for handouts; we are asking for fairness and for you to listen. Black in Cancer started as a networking group to support and encourage future leaders in biomedicine. We promise to provide a continuous stream of intentional actions to increase the number of Black people in cancer research and medicine.

H.J. Henderson reports grants and other from Cancer Research UK (CRUK), Fred Hutchinson Cancer Research Center, and Tigerlily Foundation. S. Bell reports grants from Cancer Research UK, Fred Hutchinson Cancer Research Center, and Tigerlily Foundation.