Perspectives on Disparities and Equity in Cancer Outcomes: A Call to Action.

Abstract

Despite remarkable progress in cancer prevention, treatment, and survivorship in the United States over the past 3 decades, there remain considerable disparities in cancer incidence and mortality among various groups based on race, ethnicity, and other social determinants of health. For most cancer types, African Americans have the highest mortality rate and lowest survival rate of any racial and ethnic group. Here the author highlights some of the factors responsible for cancer health disparities and proposes that cancer health equity is a fundamental human right. These factors include inadequate health insurance coverage, medical mistrust, lack of diversity in the workforce, and social and economic exclusion. Recognizing that health disparities do not exist in isolation but are part of a complex set of problems associated with education, housing, employment, health insurance, and community structures, the author contends that the challenge cannot be solved by public health measures alone but would require a multifaced and coordinated approach involving several sectors of the economy-business, schools, financial institutions, agriculture, and urban planning. Several immediate and medium-term action items are proposed to set the foundation for sustained efforts that would have an impact in the long term. These include developing culturally tailored interventions through community engagement to enhance uptake of cancer screening and clinical trials among racial and ethnic minorities and other medically underserved patients, expanding access to equitable and affordable quality health care by increasing access to health insurance, and prioritizing investment in early-career cancer researchers to enhance diversity and improve equity in the workforce.