4.7 Review

Cancer health disparities in racial/ethnic minorities in the United States

Journal

BRITISH JOURNAL OF CANCER
Volume 124, Issue 2, Pages 315-332

Publisher

SPRINGERNATURE
DOI: 10.1038/s41416-020-01038-6

Keywords

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Categories

Funding

  1. NIH/NCI [K01CA211965, R01CA204797, R01CA223978, U54CA233306, P30CA093373, R21CA199631, R01CA238087, SC1 GM127276-05, U54 CA163071, R01CA228357, U01CA164974]
  2. UCSF Helen Diller Family Comprehensive Cancer Center through the San Francisco Cancer Initiative (SF CAN)
  3. California Initiative to Advance Precision Medicine [CA-OPR18111]
  4. NIH-NCI [R01CA1009767, R01CA109767-S1, R01CA059706, R01CA154823]
  5. Joan Rombauer Pancreatic Cancer Fund
  6. United States Public Health Service (NIH) [CA206010]
  7. A. Alfred Taubman Medical Research Institute of the University of Michigan
  8. Auburn Community Cancer Endowed Chair in Basic Science
  9. NIH/NIMHD
  10. NIAID [U54MD007587]
  11. UCSF Helen Diller Family Comprehensive Cancer Center through SF CAN
  12. Survivorship Research Initiative through NCI [P30-CA051008]
  13. CONICET, Argentina
  14. Center for Global Health, NCI
  15. Morris and Horowitz Families Endowed Professorship
  16. Komen Scholars Leadership Grant [SAC160072]
  17. Fashion Footwear Association of New York Charitable Foundation
  18. Susan G. Komen Foundation Leadership Grant [SAC180086]
  19. Karin Grunebaum Foundation
  20. NHLBI
  21. NIMHD Divisions of Intramural Research
  22. Instituto Nacional de Cancerologia, Colombia [19010300411]
  23. Colciencias [19010300431]
  24. NCI grant [P30CA014089]
  25. Breast Cancer Research Foundation [BCRF-16-168]
  26. Dr. Norman & Melinda Payson Professorship in Medical Oncology
  27. Conquer Cancer Research Professorship in Breast Cancer Disparities
  28. NIGMS [R01-5R01GM118578-04]
  29. NH/NIGMS [P30GM114732, 1P20GM121288, NIH/NCI 1P20CA20292201A1]
  30. CPML-5 [P50GM115279-05]

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There are significant disparities in cancer incidence and outcomes by race/ethnicity, influenced by structural, socioeconomic, socio-environmental, behavioural, and biological factors. Research has mainly focused on populations of European origin, with limitations in clinical and genetic data potentially widening health disparities.
There are well-established disparities in cancer incidence and outcomes by race/ethnicity that result from the interplay between structural, socioeconomic, socio-environmental, behavioural and biological factors. However, large research studies designed to investigate factors contributing to cancer aetiology and progression have mainly focused on populations of European origin. The limitations in clinicopathological and genetic data, as well as the reduced availability of biospecimens from diverse populations, contribute to the knowledge gap and have the potential to widen cancer health disparities. In this review, we summarise reported disparities and associated factors in the United States of America (USA) for the most common cancers (breast, prostate, lung and colon), and for a subset of other cancers that highlight the complexity of disparities (gastric, liver, pancreas and leukaemia). We focus on populations commonly identified and referred to as racial/ethnic minorities in the USA-African Americans/Blacks, American Indians and Alaska Natives, Asians, Native Hawaiians/other Pacific Islanders and Hispanics/Latinos. We conclude that even though substantial progress has been made in understanding the factors underlying cancer health disparities, marked inequities persist. Additional efforts are needed to include participants from diverse populations in the research of cancer aetiology, biology and treatment. Furthermore, to eliminate cancer health disparities, it will be necessary to facilitate access to, and utilisation of, health services to all individuals, and to address structural inequities, including racism, that disproportionally affect racial/ethnic minorities in the USA.

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