AACR Releases Cancer Disparities Progress Report

Publication includes key cancer disparities facts and figures, provides comprehensive overview of latest research, and calls for health equity for all

PHILADELPHIA — The American Association for Cancer Research (AACR) today released its Cancer Disparities Progress Report 2022. The publication raises awareness of the enormous toll that cancer exacts on racial and ethnic minorities and other medically underserved populations, while highlighting areas of recent progress in reducing cancer health disparities. The report also provides specific recommendations for achieving health equity, which is a basic human right for all people regardless of their race, ethnicity, sexual orientation, gender identity, socioeconomic status, or community in which they live. It is the second AACR report on this topic.

CANCER DISPARITIES: AN ONGOING PUBLIC HEALTH CHALLENGE

As the report explains, complex and interrelated factors called social determinants of health (SDOH) have a major impact on people’s health, well-being, and quality of life. SDOH are defined as the social, economic, and physical conditions in the places where people are born and where they live, learn, work, play, and age that can affect their health, well-being, and quality of life. The long history of racism and other structural, social, and institutional injustices is a key contributor to adverse SDOH in the U.S., creating conditions that perpetuate cancer disparities and other health inequities for racial and ethnic minorities and other medically underserved populations. Examples of these disparities as outlined in the AACR Cancer Disparities Progress Report 2022 are below.

Key Cancer Disparities Statistics

• Both incidence and mortality rates for multiple myeloma in the Black population are at least twice as high as rates in the non-Hispanic White (NHW) population.
• The Hispanic population has a mortality rate of liver cancer that is nearly double that of the NHW population.
• The incidence rate for kidney cancer in the American Indian/Alaska Native population is 80 percent higher compared to the NHW population. This group also has the highest liver cancer incidence rate of any major racial or ethnic group in the U.S.
• 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 deaths. In persistently poor counties, mortality rates were 12.3 percent higher for all cancer types, and more than 40 percent higher for stomach cancer, when compared to counties that are not persistently poor.
• Compared to those living in urban areas, individuals living in rural areas have 17 percent higher death rates from all cancers combined, with 34 percent higher death rates from lung cancer and 23 percent higher death rates from colorectal cancer.

“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. Inequities such as disparate access to clinical research and optimal cancer care place vulnerable communities at risk for adverse outcomes and impair our ability to understand the root causes of cancer,” said Lisa A. Newman, MD, MPH, chair, AACR Cancer Disparities Progress Report 2022 Steering Committee and chief, Section of Breast Surgery, NewYork-Presbyterian and Weill Cornell Medicine in New York. “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.”

MAKING PROGRESS FOR ALL

Research is driving tremendous breakthroughs against cancer, but the grim reality is that these advances have not benefited everyone equally. The AACR Cancer Disparities Progress Report 2022 notes 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 address these gaps in cancer research and knowledge, the report emphasizes the following important steps.

Closing the Gap on Cancer Disparities

• Diversify patient accrual on clinical trials so that participants represent all potential patient groups who might benefit from the therapeutic being tested.
• Create large and inclusive genomic databases to increase our knowledge of the cancer-related changes that influence cancer incidence, progression, and response to treatment in patients from different ancestral groups.
• Disaggregate cancer data to account for the heterogeneity of people within racial, ethnic, sexual, and gender minority groups.

Encouragingly, awareness of cancer disparities is increasing, and progress against these persistent, pervasive, and unjust inequities is being made, slowly but steadily.

Progress Against Cancer Disparities

• The disparity in overall cancer mortality rates between Black and White people has narrowed from 26 percent in 2000 to 13 percent in 2019.
• Improving access improves outcomes. The expansion of Medicaid under the Affordable Care Act (ACA) has nearly eliminated the disparity between Black and White patients initiating chemotherapy within a month of cancer diagnosis, and the disparity between Hispanic and White women receiving timely mammograms.
• Cancer screening programs that adopt culturally tailored approaches and reduce structural barriers have demonstrated success in improving screening rates among marginalized groups, thereby improving the likelihood of detecting cancer early, when it is more likely that the patient can be treated successfully.
• AACR Project GENIE, an international cancer registry, contains real-world data from more than 121,000 patients, 13.4 percent of whom are from racial and ethnic minority groups. The All of Us Research Program of the National Institutes of Health (NIH), which aims to build one of the most diverse health databases in history, has enrolled 100,000 people, 50 percent of whom are from underrepresented groups.
• NIH and the National Cancer Institute (NCI) have recently created several initiatives to support underrepresented minority scientists in the research workforce, a necessary step toward achieving health equity.

THE AACR CALL TO ACTION

The report underscores that there is still much progress to be made, and ends with a call to action urging policy makers and other stakeholders committed to eliminating cancer health disparities to:

• Increase federal funding for medical research and public health initiatives that are tasked with reducing cancer health disparities; specifically, provide $49 billion for NIH’s base budget in fiscal year (FY) 2023; increase funding for the National Institute on Minority Health and Health Disparities; and fund the NCI at $7.766 billion in FY 2023.
• Improve collection of disaggregated data for racial, ethnic, sexual, and gender minority groups.
• Increase diversity in clinical trial participation.
• 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 on behalf of the Congressional Tri-Caucus, comprised of the Congressional Black Caucus, Congressional Asian Pacific American Caucus, and the Congressional Hispanic Caucus.

“We are very proud to release this second edition of the AACR Cancer Disparities Progress Report, a cornerstone of the AACR’s educational and advocacy efforts to address this important issue,” said Margaret Foti, PhD, MD (hc), chief executive officer of the AACR. “Cancer health disparities are a complex and multifaceted problem that will require a multidisciplinary and collaborative approach, as well as robust, sustained, and predictable federal funding for innovative research. The AACR is committed to working with all stakeholders to achieve the bold vision of health equity for all.”