Disparities in Surgical Oncology: Management of Advanced Cancer

Abstract

Significant variations in the patterns of care, incidence, and mortality rates of several common cancers have been noted. These disparities have been attributed to a complex interplay of factors, including genetic, environmental, and healthcare-related components. Within this review, primarily focusing on commonly occurring cancers (breast, lung, colorectal), we initially summarize the burden of these disparities with regard to incidence and screening patterns. We then explore the interaction between several proven genetic, epigenetic, and environmental influences that are known to contribute to these disparities.

FIG. 1

Outline of factors contributing to cancer health disparities, as well as the interconnected nature of these influences (created with BioRender.com)

FIG. 2

Trend in the incidence of a all cancers in men and women, and b mortality from all cancers in men and women. Incidence data from SEER Research Data, 13 Registries, Nov 2019 Sub (1992–2017), and mortality data from Mortality-All COD, Aggregated with State, Total US (1969–2018). Rates are age-adjusted per 100,000. SEER Surveillance, Epidemiology, and End Results

FIG. 3

Incidence of the most common cancers of White and Black American a men and b women between 1992 and 2017. Data from SEER Research Data, 13 Registries, Nov 2019 Sub (1992–2017). Rates are age-adjusted per 100,000. SEER Surveillance, Epidemiology, and End Results

FIG. 4

Trend in the incidence of a colorectal cancer, b lung/bronchus cancer, c breast cancer in women, and d prostate cancer in men. Data from SEER Research Data, 13 Registries, Nov 2019 Sub (1992–2017). Rates are age-adjusted per 100,000. SEER Surveillance, Epidemiology, and End Results

FIG. 5

Trend in the mortality of a colorectal cancer, b lung/bronchus cancer, c breast cancer in women, and d prostate cancer in men. Mortality data from Mortality-All COD, Aggregated with State, Total US (1969–2018). Rates are age-adjusted per 100,000.