A Message from AACR

We are now witnessing spectacular progress against cancer in the United States, with more people living longer and fuller lives after a cancer diagnosis than ever before. This is the result of unprecedented advances in our understanding of cancer biology and in cutting-edge technologies that are allowing us to target the molecular drivers of the disease with increasing precision. Unfortunately, large segments of the US population have not benefited from these advances and continue to shoulder a disproportionate cancer burden. Cancer disparities in the United States stem from a long history of systemic inequities and are perpetuated by a range of structural and social factors that adversely impact human health. Also contributing to the disparities is the serious lack of diversity in the cancer research and care workforce attributable to the same institutional and societal injustices that limit opportunities for higher education among minoritized communities.

Launched in 2020, the Cancer Disparities Progress Report to Congress and the American public is a cornerstone of AACR’s educational and advocacy efforts to achieve health equity. The AACR Cancer Disparities Progress Report 2024 highlights areas of recent progress in understanding and reducing cancer disparities. It also emphasizes the vital need for continued transformative research and for increased collaborations to ensure that advances against cancer benefit all patients, regardless of their race, ethnicity, age, sexual orientation, gender identity, socioeconomic status, or geographic location.

Racial and ethnic minority population groups in the United States have long experienced cancer disparities. As one striking example, although the overall cancer incidence rates among Black and American Indian or Alaska Native (AI/AN) people are lower compared to the White population, Black and Indigenous individuals have the highest overall cancer death rates of all US racial or ethnic groups. Alarming disparities also exist for sexual or gender minority (SGM) populations, individuals residing in rural areas, and/or those living under persistent poverty. Additionally, it is concerning that we do not have a precise understanding of the true burden of cancer disparities for many of the vulnerable populations because of a lack of comprehensive, disaggregated health data. For example, most cancer databases lack information about sexual orientation or gender identity making it difficult to discern the true burden of cancer in SGM populations. In addition, health records for Native Hawaiian and other Pacific Islander populations are often combined with those of Asian populations, thus masking the true extent of health disparities in this population group.

Encouragingly, some progress has been made in reducing cancer disparities. As one example, the disparities in overall cancer mortality between Black and White populations have narrowed significantly over the past two decades. Additionally, several clinical studies have demonstrated that racial and ethnic disparities in outcomes for many cancer types can be drastically reduced if all patients have equal access to standard treatments. However, the goal of achieving health equity for all medically underserved populations has yet to be realized.

As a scientific organization focused on preventing and curing all cancers, the AACR’s principle focus has been and will remain diversity, equity, inclusion, and access. AACR is fiercely committed to advancing the science of cancer disparities by catalyzing discoveries in basic, translational, and clinical research as well as by underscoring the critical importance of population sciences, all of which are vital to identifying the systemic roots of health disparities. As highlighted throughout this report, an integrated approach that accounts for the interplay of an individual’s living environments and exposures with biology and cancer risks is critical to cancer disparities research.

Cancer represents genetic aberrations at its root. Research has shown that these aberrations are driven by a range of factors and may differ by patients’ ancestral backgrounds. Therefore, a comprehensive understanding of cancer relies on biospecimen and research models that represent diverse populations. As we look into the future, we strongly believe that a deeper understanding of the differences in cancer biology related to patients’ ancestral backgrounds is key if we are to achieve health equity for all patients. Data repositories, such as the AACR Project Genomics Evidence Neoplasia Information Exchange® (AACR Project GENIE®), are providing novel insights into this very issue.

Cancer disparities are a complex and multifaceted problem necessitating multidisciplinary and collaborative approaches to identify effective solutions. AACR continues to be a trailblazer for the cancer disparities research community by catalyzing collaborations, bringing together all sectors in public health, and disseminating critical knowledge to the relevant stakeholders. One outstanding example is the pioneering AACR Conference on The Science of Cancer Health Disparities in Racial/ Ethnic Minorities and the Medically Underserved, the 17th edition of which will be held in September 2024. More recently, AACR has formed the AACR Cancer Centers Alliance, a collaborative initiative with US cancer centers. One of the major goals of the Alliance is to create new and inclusive opportunities for the next generation of cancer researchers and clinicians and thereby create a workforce that is reflective of the diverse communities that the cancer centers serve.

Research has shown that teams that are diverse in terms of race, ethnicity, opinions, experiences, and other sociodemographic characteristics are more innovative. We believe that increasing diversity in the cancer workforce and nurturing the professional development of underrepresented researchers will make future cancer research more equitable. For more than two decades, the AACR Minorities in Cancer Research and AACR Women in Cancer Research constituency groups have been leading the way in increasing the number, participation, visibility, and recognition of minority and women scientists. Additionally, AACR supports cancer disparities research and cancer researchers from underrepresented backgrounds through a wide range of national and international grant mechanisms.

Clinical trials are an integral extension of quality cancer care. To achieve the full potential of precision cancer medicine, an approach to treatment that harnesses our growing knowledge of the specific characteristics of individual patients and their cancers, it is essential that all segments of the population are adequately represented in cancer clinical trials. However, as underscored in this report as well as in past editions, participation in cancer clinical trials continues to be low, and there is a serious lack of diversity among those who do participate. In this regard, AACR has partnered with Bristol Myers Squibb Foundation to launch the Robert A. Winn Diversity in Clinical Trials program, which is designed to train early- stage physician scientists in the fundaments of clinical trial design and the science of community outreach and engagement. These physician-scientists are from underrepresented backgrounds and have demonstrated a commitment to increasing diversity in clinical research.

Clearly, we are in an era of extraordinary scientific progress against cancer. Thanks to the new wave of scientific discoveries and technological innovations, the overall cancer death rate in the US is declining steadily, and we are now poised to deliver even more transformative breakthroughs for our patients. But along with these advances in cancer science and medicine, we must be equally committed to ensuring that no populations or communities are left behind. As powerfully described by the Reverend Dr. Martin Luther King, Jr., during the Medical Committee for Human Rights 1966 meeting in Chicago: “Of all the forms of inequality, injustice in health is the most shocking and inhuman because it often results in physical death.” AACR is committed to working with policymakers to ensure that health equity is a national priority. By providing robust, sustained, and predictable funding for innovative research, Congress will continue to be of enormous assistance in eliminating cancer disparities and achieving the vision of health equity for all patient populations.

Robert A. Winn, MD, FAACR
AACR Cancer Disparities Progress Report 2024 Steering Committee

Margaret Foti, PhD, MD (hc)
Chief Executive Officer
American Association for Cancer Research

Next Section: Executive Summary