Although overall cancer incidence and mortality are declining across all population groups, compared with White individuals, racial and ethnic minorities and other medically underserved populations continue to shoulder a disproportionate burden of cancer, according to the study results published in the American Association for Cancer Research (AACR) Cancer Disparities Progress Report 2022. And while disparity in cancer-related deaths between Black and White individuals has been narrowing, Black individuals still have the highest rate of overall cancer mortality.
Complex and interrelated factors—including social determinants of health and the long history of racism and other structural, social, and institutional injustices in the United States—create conditions that perpetuate cancer disparities and other health inequities for racial and minority underserved populations, according to the report’s findings.
Funding research to understand and address cancer health disparities “is a vital national investment to achieve an equitable future for all populations,” concluded the report.
Key Findings
Some of the main statistics on cancer disparities in the AACR Cancer Disparities Progress Report 2022 include:
- Both the incidence and mortality rates for multiple myeloma in Black individuals are at least twice as high as the rates in non-Hispanic White individuals.
- Hispanic individuals have a mortality rate of liver cancer that is nearly double that of non-Hispanic White individuals.
- American Indian and Alaska Native individuals have an 80% higher incidence rate of kidney cancer compared with non-Hispanic White individuals. American Indian and Alaska Natives also have the highest incidence rate of liver cancer than any major racial or ethnic group in the United States.
- Transgender men are more than twice as likely as cisgender men to be diagnosed with cancer.
- Residents of low-income areas share a disproportionate burden of cancer mortality. For example, in persistently poor counties, morality rates were 12.3% higher for all cancer types, and more than 40% higher for stomach cancer, compared to counties that are not persistently poor.
- Compared to those living in urban areas, individuals living in rural areas have 17% higher death rates from all cancers combined, with 34% higher death rates from lung cancer and 23% higher death rates from colorectal cancer.
Policy Recommendations
The report noted that racial and ethnic minorities are severely underrepresented in clinical trials, and scientific understanding of how cancer develops in these groups is significantly lacking. To close the gap in cancer disparities, the report recommends:
- Diversifying patient accrual in clinical trials to ensure that participants represent all potential patient groups that might benefit from the therapeutics being investigated.
- Creating large and inclusive genomic databases to increase scientific knowledge of the cancer-related changes that influence cancer incidence, progression, and response to treatment in patients from different ancestral groups.
- Disaggregating cancer data to account for the heterogeneity of people within racial, ethnic, sexual, and gender minority groups.
Call to Action
To reduce cancer health disparities, the AACR is calling upon policymakers to immediately take the following steps:
- Increase federal funding for medical research and public health initiatives that are tasked with reducing cancer health disparities, specifically by providing $49 billion for the National Institutes of Health base budget in fiscal year (FY) 2023; increasing funding for the National Institute on Minority Health and Health Disparities; and funding the National Cancer Institute at $7.77 billion in FY 2023.
- Improve the collection of disaggregated data for racial, ethnic, sexual, and gender minority groups.
- Increase diversity in clinical trial participation. The report also calls for Congress to pass the Diverse and Equitable Participation in Clinical Trials Act (DEPICT, H.R. 6584) to provide the U.S. Food and Drug Administration with the authority to require diverse representation in clinical trials.
- Enhance cancer prevention and screening efforts to reduce the burden of cancer among all medically underserved populations.
- Expand access to equitable and affordable quality health care.
- Build a more diverse STEMM (science, technology, engineering, mathematics, and medicine) trainee pipeline and cancer research and health-care workforce.
- Enact comprehensive legislation to eliminate racial and ethnic health inequities, specifically the Health Equity and Accountability Act (HEAA), introduced by the Congressional Black Caucus, Congressional Asian Pacific American Caucus, and the Congressional Hispanic Caucus.
Achieving Health Equity for All Patients
“Advances in screening and treatment have resulted in millions of cancer patients continuing to live long and productive lives, but efforts to make this progress equitably available to all population subsets continue to be inadequate,” said Lisa A. Newman, MD, MPH, Chair of the AACR Cancer Disparities Report 2022 Steering Committee and Chief, Section of Breast Surgery at New York-Presbyterian and Weill Cornell Medicine in New York, in a statement.
Lisa A. Newman, MD, MPH
“We cannot achieve the ultimate goal of eradicating cancer as a life-threatening disease for all unless we comprehensively address the genetic, environmental, and lifestyle features that characterize the entirety of our diverse patient population. The AACR Cancer Disparities Progress Report 2022 explores these issues and provides an action plan for addressing them, which includes a blueprint for strengthening the diversity of our oncology workforce, so that we enlist the brilliance and creativity of individuals from all communities as allies in the war on cancer.”
To learn more about the report, visit cancerprogressreport.aacr.org/disparities.
