AACR Report Highlights Disparities in Cancer and the Need for Health Equity

Although innovations in cancer treatment have driven down overall cancer death rates and increased the number of survivors living with cancer, that progress has not benefitted everyone with cancer equally, according to a new report from the American Association for Cancer Research (AACR).

The inaugural Cancer Disparities Progress Report 2020 highlights the toll cancer exacts on racial and ethnic minorities and other underserved populations. Right now, this is particularly important because many of those same population groups experiencing cancer health disparities are also facing disparities related to the coronavirus disease 2019 (COVID-19) pandemic.

“This inaugural and historic progress report will provide the world with a comprehensive baseline understanding of our progress toward recognizing and eliminating cancer health disparities from the standpoint of biological factors, clinical management, population science, public policy, and workforce diversity,” John D. Carpten, PhD, chair of both the AACR Cancer Disparities Progress Report 2020 Steering Committee and the AACR Minorities in Cancer Research Council, said in a statement.

The report highlighted some key data on cancer health disparities. Compared with White individuals:

• Black men have a 111% higher risk of dying from prostate cancer and Black women have a 39% higher risk of dying of dying from breast cancer
• Asian/Pacific Islander adults are twice as likely to die from stomach cancer
• American Indian/Alaska Native adults are twice as likely to develop liver and bile duct cancer
• Hispanic children and adolescents are 20% and 38%, respectively, more likely to develop leukemia than non-Hispanic White children and adolescents

The disparities are not just seen by race or ethnicity:

• Men living in Kentucky have a 3.5 times higher incidence and death rate compared with men living in Utah
• The colorectal cancer death rate for men living in the poorest counties in the United States is 35% higher than men living in the most affluent counties
• Bisexual women are 70% more likely to be diagnosed with cancer than heterosexual women

Some encouraging news is that differences in the overall cancer incidence and death rates are now less pronounced among racial and ethnic groups compared with the early 2000s. The decline has been greatest among Blacks (30%). The decline among American Indians/Alaska Natives was only about 11%. Among Whites, Hispanics, and Asians/Pacific Islanders, the declines in overall cancer death rates were about 20%.

The report also highlighted the fact that racial and ethnic minorities are underrepresented in clinical trials. For instance, Blacks account for about 20% of new multiple myeloma cases, but they only account for 10% of participants in the clinical trials that led to daratumumab being approved to treat the disease. While the incidence of prostate cancer is almost 70% higher among Black men than among White men, fewer than 10% of the patients recruited for 2 recent clinical trials for prostate cancer treatments were Black men.

Finally, in addition to COVID-19 disproportionately affecting racial and ethnic minorities, the pandemic has disrupted cancer care for many patients. Delays in screening, diagnosis, and treatment are expected to exacerbate cancer health disparities in the future, according to the report.

“Health disparities in general, and cancer health disparities in particular, are an enormous public health challenge,” said Margaret Foti, PhD, MD (hc), CEO of the AACR. “While the pandemic has highlighted and sadly exacerbated many of these issues, confronting and addressing health inequities has been a high priority for the AACR for decades.”