Cancer health disparities in racial/ethnic minorities in the United States

Valentina A Zavala¹, Paige M Bracci², John M Carethers³, Luis Carvajal-Carmona^{4

5}, Nicole B Coggins⁵, Marcia R Cruz-Correa⁶, Melissa Davis⁷, Adam J de Smith⁸, Julie Dutil⁹, Jane C Figueiredo¹⁰, Rena Fox¹, Kristi D Graves¹¹, Scarlett Lin Gomez^{2

12}, Andrea Llera¹³, Susan L Neuhausen¹⁴, Lisa Newman^{7

15}, Tung Nguyen¹, Julie R Palmer¹⁶, Nynikka R Palmer¹⁷, Eliseo J Pérez-Stable^{18

19}, Sorbarikor Piawah^{1

20}, Erik J Rodriquez¹⁸, María Carolina Sanabria-Salas²¹, Stephanie L Schmit²², Silvia J Serrano-Gomez²³, Mariana C Stern²⁴, Jeffrey Weitzel^{14

25}, Jun J Yang²⁶, Jovanny Zabaleta²⁷, Elad Ziv¹, Laura Fejerman²⁸

Affiliations

¹ Division of General Internal Medicine, Department of Medicine, University of California, San Francisco, San Francisco, CA, USA.
² Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA.
³ Departments of Internal Medicine and Human Genetics, and Rogel Cancer Center, University of Michigan, Ann Arbor, MI, USA.
⁴ University of California Davis Comprehensive Cancer Center and Department of Biochemistry and Molecular Medicine, School of Medicine, University of California Davis, Sacramento, CA, USA.
⁵ Genome Center, University of California Davis, Davis, CA, USA.
⁶ Department of Cancer Biology, University of Puerto Rico Comprehensive Cancer Center, San Juan, Puerto Rico.
⁷ Division of Breast Surgery, Department of Surgery, NewYork-Presbyterian/Weill Cornell Medical Center, New York, NY, USA.
⁸ Center for Genetic Epidemiology, University of Southern California Keck School of Medicine, Los Angeles, CA, USA.
⁹ Cancer Biology Division, Ponce Research Institute, Ponce Health Sciences University, Ponce, Puerto Rico.
¹⁰ Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
¹¹ Department of Oncology, Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC, USA.
¹² Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, San Francisco, CA, USA.
¹³ Laboratorio de Terapia Molecular y Celular, IIBBA, Fundación Instituto Leloir, CONICET, Buenos Aires, Argentina.
¹⁴ Department of Population Sciences, Beckman Research Institute of City of Hope, Duarte, CA, USA.
¹⁵ Interdisciplinary Breast Program, New York-Presbyterian/Weill Cornell Medical Center, New York, NY, USA.
¹⁶ Slone Epidemiology Center at Boston University, Boston, MA, USA.
¹⁷ Department of Medicine, Zuckerberg San Francisco General Hospital and Trauma Center, University of California, San Francisco, San Francisco, CA, USA.
¹⁸ Division of Intramural Research, National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD, USA.
¹⁹ Office of the Director, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD, USA.
²⁰ Division of Hematology/Oncology, Department of Medicine, University of California San Francisco, San Francisco, CA, USA.
²¹ Subdirección de Investigaciones - Instituto Nacional de Cancerología de Colombia, Bogotá, Colombia.
²² Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA.
²³ Grupo de investigación en biología del cáncer, Instituto Nacional de Cancerología, Bogotá, Colombia.
²⁴ Departments of Preventive Medicine and Urology, Keck School of Medicine of USC, Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA, USA.
²⁵ Department of Medical Oncology and Therapeutics Research, City of Hope Comprehensive Cancer Center, Duarte, CA, USA.
²⁶ Department of Pharmaceutical Sciences, Department of Oncology, St. Jude Children's Research Hospital, Memphis, TN, USA.
²⁷ Department of Pediatrics and Stanley S. Scott Cancer Center LSUHSC, New Orleans, LA, USA.
²⁸ Division of General Internal Medicine, Department of Medicine, University of California, San Francisco, San Francisco, CA, USA. laura.fejerman@ucsf.edu.

PMID: 32901135
PMCID: PMC7852513
DOI: 10.1038/s41416-020-01038-6

Review

Cancer health disparities in racial/ethnic minorities in the United States

Valentina A Zavala et al. Br J Cancer. 2021 Jan.

. 2021 Jan;124(2):315-332.

doi: 10.1038/s41416-020-01038-6. Epub 2020 Sep 9.

Authors

Affiliations

¹ Division of General Internal Medicine, Department of Medicine, University of California, San Francisco, San Francisco, CA, USA.
² Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA.
³ Departments of Internal Medicine and Human Genetics, and Rogel Cancer Center, University of Michigan, Ann Arbor, MI, USA.
⁴ University of California Davis Comprehensive Cancer Center and Department of Biochemistry and Molecular Medicine, School of Medicine, University of California Davis, Sacramento, CA, USA.
⁵ Genome Center, University of California Davis, Davis, CA, USA.
⁶ Department of Cancer Biology, University of Puerto Rico Comprehensive Cancer Center, San Juan, Puerto Rico.
⁷ Division of Breast Surgery, Department of Surgery, NewYork-Presbyterian/Weill Cornell Medical Center, New York, NY, USA.
⁸ Center for Genetic Epidemiology, University of Southern California Keck School of Medicine, Los Angeles, CA, USA.
⁹ Cancer Biology Division, Ponce Research Institute, Ponce Health Sciences University, Ponce, Puerto Rico.
¹⁰ Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
¹¹ Department of Oncology, Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC, USA.
¹² Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, San Francisco, CA, USA.
¹³ Laboratorio de Terapia Molecular y Celular, IIBBA, Fundación Instituto Leloir, CONICET, Buenos Aires, Argentina.
¹⁴ Department of Population Sciences, Beckman Research Institute of City of Hope, Duarte, CA, USA.
¹⁵ Interdisciplinary Breast Program, New York-Presbyterian/Weill Cornell Medical Center, New York, NY, USA.
¹⁶ Slone Epidemiology Center at Boston University, Boston, MA, USA.
¹⁷ Department of Medicine, Zuckerberg San Francisco General Hospital and Trauma Center, University of California, San Francisco, San Francisco, CA, USA.
¹⁸ Division of Intramural Research, National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD, USA.
¹⁹ Office of the Director, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD, USA.
²⁰ Division of Hematology/Oncology, Department of Medicine, University of California San Francisco, San Francisco, CA, USA.
²¹ Subdirección de Investigaciones - Instituto Nacional de Cancerología de Colombia, Bogotá, Colombia.
²² Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA.
²³ Grupo de investigación en biología del cáncer, Instituto Nacional de Cancerología, Bogotá, Colombia.
²⁴ Departments of Preventive Medicine and Urology, Keck School of Medicine of USC, Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA, USA.
²⁵ Department of Medical Oncology and Therapeutics Research, City of Hope Comprehensive Cancer Center, Duarte, CA, USA.
²⁶ Department of Pharmaceutical Sciences, Department of Oncology, St. Jude Children's Research Hospital, Memphis, TN, USA.
²⁷ Department of Pediatrics and Stanley S. Scott Cancer Center LSUHSC, New Orleans, LA, USA.
²⁸ Division of General Internal Medicine, Department of Medicine, University of California, San Francisco, San Francisco, CA, USA. laura.fejerman@ucsf.edu.

PMID: 32901135
PMCID: PMC7852513
DOI: 10.1038/s41416-020-01038-6

Abstract

There are well-established disparities in cancer incidence and outcomes by race/ethnicity that result from the interplay between structural, socioeconomic, socio-environmental, behavioural and biological factors. However, large research studies designed to investigate factors contributing to cancer aetiology and progression have mainly focused on populations of European origin. The limitations in clinicopathological and genetic data, as well as the reduced availability of biospecimens from diverse populations, contribute to the knowledge gap and have the potential to widen cancer health disparities. In this review, we summarise reported disparities and associated factors in the United States of America (USA) for the most common cancers (breast, prostate, lung and colon), and for a subset of other cancers that highlight the complexity of disparities (gastric, liver, pancreas and leukaemia). We focus on populations commonly identified and referred to as racial/ethnic minorities in the USA-African Americans/Blacks, American Indians and Alaska Natives, Asians, Native Hawaiians/other Pacific Islanders and Hispanics/Latinos. We conclude that even though substantial progress has been made in understanding the factors underlying cancer health disparities, marked inequities persist. Additional efforts are needed to include participants from diverse populations in the research of cancer aetiology, biology and treatment. Furthermore, to eliminate cancer health disparities, it will be necessary to facilitate access to, and utilisation of, health services to all individuals, and to address structural inequities, including racism, that disproportionally affect racial/ethnic minorities in the USA.

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Conflict of interest statement

The authors declare no competing interests.

Figures

**Fig. 1. Lung cancer mortality rates and tobacco use among adult men in the United States by racial/ethnic category.**
Bars in light gray represent age-adjusted lung cancer mortality rates in the USA for the period 2013–2017 and bars in dark gray represent tobacco use among adult men as reported by the 2016 National Health Interview Survey, stratified by racial/ethnic category.

See this image and copyright information in PMC

References

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Cancer health disparities in racial/ethnic minorities in the United States

Affiliations

Cancer health disparities in racial/ethnic minorities in the United States

Authors

Affiliations

Abstract

Conflict of interest statement

Figures

References

Publication types

MeSH terms

Grants and funding

LinkOut - more resources

Full Text Sources

Medical

Miscellaneous