During my AACR presidency, I am focusing on cancer health disparities and what we as scientists can do to reverse an embarrassing truth in our society today. That is, being born into a non-white race and/or lower socioeconomic class today still means having a greater chance of dying from a diagnosis of an advanced cancer at a younger age. Underserved and minority populations bear unfavorable cancer risk, survival, and quality of life, compared with economically advantaged and majority groups. Multilevel issues of place confront rural/frontier, urban, and immigrant populations and further compound disparities. We cannot realize our goal of eliminating cancer without addressing these disparities in cancer risk factors, incidence, mortality, and other outcomes.
In a special collection celebrating the 10th anniversary of the AACR Cancer Health Disparities Conference, the editors of Cancer Epidemiology, Biomarkers & Prevention have compiled important articles published over the past 10 years focusing on cancer disparities. The collection is available as an offprint at the conference and is accessible online (1). The articles provide an overview of the major issues preventing us from achieving our goal of living in a cancer-free world.
Global rates of cancer and cancer in certain underserved populations—for example, Appalachian, Asian American, and rural populations—are described to identify areas for research (2–5). Powell and colleagues (6) describe the different genetic profiles in African American versus European American men, highlighting the importance of biology in disparities. The disparity in endometrial cancer in black women versus other populations is described by Cote and colleagues (7), outlining reasons for the excess risk of this cancer in black women. Breast cancer subtypes in women of Mexican descent are discussed by Martinez and colleagues (8), describing unique causes of disparate cancer outcomes in this population. Early detection tests and cancer prevention strategies, although they can reduce cancer incidence and mortality, are often underutilized in populations experiencing disparities, as highlighted by Klabunde and colleagues (9) for colorectal cancer and among African Americans, and for low-income populations by Andersen and colleagues (10). Comorbidities, which are more prevalent among underserved populations, often impact treatment choices. Survival is also impacted by comorbidities as highlighted in the work by Wu and colleagues examining survival after a cancer diagnosis by race and ethnicity (11). Finally, the communication revolution might be harnessed to address disparities as discussed by Viswanath and colleagues (12).
This comprehensive overview of the trends, causes, and strategies impacting cancer disparities from genes to policy can serve as a roadmap for a strategic plan to enact research and policy initiatives to reduce disparities and realize a cancer-free world for everyone.
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