Conclusion

The AACR Cancer Disparities Progress Report to Congress and the American public is a cornerstone of AACR’s educational and advocacy efforts in the field of health equity. This second edition of the report is a timely update on the state of knowledge and recent progress against disparities across the continuum of cancer science and medicine.

There has been great progress against cancer in the United States in recent decades, as illustrated by the declining overall cancer mortality rate and the increasing number of cancer survivors. Furthermore, differences in the overall cancer death rate among U.S. racial and ethnic groups are less pronounced now than they have ever been. Despite this progress, marginalized populations continue to shoulder a disproportionate burden of cancer. For example, Black Americans have the highest overall cancer death rate among all racial and ethnic populations, and the burden of many common cancers of the digestive tract or the respiratory system is disproportionately higher in racial and ethnic minorities and other medically underserved populations. The immense toll of U.S. cancer health disparities is also felt through their significant adverse economic impact. According to one estimate, eliminating racial disparities in the incidence of just the four most common types of cancer in the U.S.—lung, colorectal, breast, and prostate—during 2002–2007, would have saved $2.3 billion in annual medical expenditures.

As discussed in the report, the reasons for cancer health disparities are complex and multifactorial. It is undeniable that a long history of structural racism and other social and institutional injustices have contributed to adverse social determinants of health, which in turn continue to perpetuate inequities, including cancer disparities, for racial and ethnic minorities and other medically underserved populations. From a cancer research and patient care standpoint, many gaps in our knowledge of cancer health disparities remain. As one example, racial and ethnic minorities continue to be underrepresented in clinical trials and cancer genomic data repositories, thus presenting challenges in realizing the full potential of precision medicine for all populations. The report emphasizes the vital need for continued transformative research and for increased collaboration among all stakeholders working toward the bold vision of health equity if we are to ensure that research-driven advances benefit all people, regardless of their race, ethnicity, age, gender, sexual orientation, socioeconomic status, or the community in which they live.

The report highlights several strategies across the cancer continuum that have shown promise in mitigating, and in some cases eliminating, cancer health disparities. For instance, recent clinical studies have shown that disparities in outcomes for several types of cancer can be eliminated if every patient has equitable access to standard treatment. Furthermore, clinical interventions that utilize patient navigation and community engagement have shown promise for improving the diversity of clinical trial participants and narrowing racial disparities in cancer treatment. Similarly, culturally tailored strategies and community outreach have been effective in increasing the adherence to cancer screening among racial and ethnic minorities. Many initiatives, such as the AACR Project GENIE and the NIH’s All of Us Program are beginning to provide deep insight into the ancestry-related differences in genetic factors that may contribute to cancer health disparities. To fully realize the collective impact of these approaches, it is imperative that all sectors in medical research continue to work together to eliminate the structural barriers to equitable care so that the advances against cancer can reach all populations.

As the first and largest professional organization in the world focused on preventing and curing all cancers, whose core values are diversity, equity, and inclusion, AACR stands in solidarity in the fight against racism, privilege, and discrimination in all aspects of life. The organization is fiercely committed to accelerating the pace of research to address the disparities in cancer burden faced by racial and ethnic minorities and other underserved populations. One outstanding example is the pioneering AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved. Now in its 15th year, this international conference brings together scientists, physicians, and other professionals from academia, industry, and government, as well as patient advocates and members of the community, to stimulate innovative approaches to research on cancer health disparities.

AACR has also long fostered training and educational initiatives that address the gaps in cancer research and care. For more than two decades, the AACR Minorities in Cancer Research constituency group has been leading the way in increasing the number, participation, visibility, and recognition of minority researchers. More recently, AACR has collaborated with the Bristol Myers Squibb Foundation and National Medical Fellowships on an initiative to train 250 community-oriented clinical trial investigators who are underrepresented in medicine or have demonstrated a commitment to increasing diversity in clinical trials; named Robert A. Winn Diversity in Clinical Trials Award Program, this new initiative is a testament to AACR’s commitment to eliminating cancer health disparities by propelling tangible improvements in cancer workforce diversity.

Every American must have equitable access to life, liberty, and the pursuit of happiness. Health care is a critical component of these “unalienable rights,” and disparities in health care are among the most significant forms of injustice. AACR is committed to working with our policy makers to ensure that we maintain a sharp focus on prioritizing cancer health disparities research. By providing adequate funding for innovative research, Congress can be of enormous assistance in eradicating cancer health disparities and ensuring that we achieve the bold vision of health equity for racial and ethnic minorities and other medically underserved populations.