AACR’s recently released annual report on cancer disparities highlights various ways that marginalized groups in the United States disproportionately suffer from the disease.

 

AACR found both that progress has been made, and that more remains to be done. For instance, the disparity in overall cancer mortality between Black and White people living in the US has been cut in half over the last 20 years. But Black Americans have the highest cancer mortality rate of any US ethnic or racial group, even though overall cancer rates are comparably lower in the Black community than amongst White Americans.

Also, some cancers have a vastly outsized presence and claim exponentially more loved ones in marginalized communities than in the White population. For example, cervical cancer rates are 56% higher and kidney cancer rates are 80% higher in Alaska Native and Native American women. Native Hawaiians and Pacific Islanders are three times as likely to die of stomach cancer and Latinx people have double the mortality rate for liver cancer.

 

Inequities Lead to Cancer… and Worse Outcomes

The prevalence of racial and cultural discrimination in the healthcare system persists. Also well-documented: systemic inequities lead to worse health outcomes for marginalized communities.

Many of the factors that increase risk of developing cancer are highest among marginalized groups. The same societal and structural inequalities that put people at risk also affect their access to quality screening and treatment – as well as the financial burden of their care. This infuriating combination costs lives.

Follow-up care is less likely to be provided in marginalized communities due to various factors such as lack of insurance, miscommunication with providers, and bias in the system. Additionally, due to the high cost of treatment, Latinx and Black patients are more likely to engage in financial coping behaviors, like skipping medications.

 

Cancer in the LGBTQIA+ Community

The report notes insufficient data on how cancer affects the LGBTQIA+ community, and that discrimination and implicit bias is still prevalent in the healthcare industry at large. And while we have pieces of information – like that transgender men are less likely to have cervical cancer screenings than cisgender women   – more research is needed to understand cancer in the transgender community specifically.

 

Possible Solutions

The report advocates for science-based public policy broadly, and expressly for increasing BIPOC participation in clinical trials. Most screenings were developed on White patients and 77% of tumor samples in The Cancer Genome Atlas are from White populations.

Increasing representation of people of color– both as trial patients and within oncology professions – is recommended. As is increasing general health education and patient advocacy, outreach to providers in marginalized communities, and reducing barriers to participation – such as associated transportation and financial burdens.