This review examined the disparities in cancer incidence and outcomes in the United States of America by race and ethnicity. Health disparities are known to result from biological factors, as well as social determinants of health.
Social forces such as racism, sexism, classism, and discrimination play a role, as do living conditions, socioeconomic status, and educational attainment. Even greater health and wellness gaps arise when clinical studies fail to include these diverse and vulnerable groups.
With regard to breast cancer disparities in the United States, the review found that African American/Black women, American Indian and Alaska Native women, and Hispanic/Latin American women experience a greater risk of mortality than non-Hispanic white women.
This increased risk of mortality is associated with such factors as more advanced stage at diagnosis, limited access to quality care, lower treatment adherence, and higher risk of developing aggressive breast cancer subtypes such as HER2+ breast cancer.
Asian American women and Hispanic/Latin American women were found to have the highest prevalence of HER2+ breast cancer. A germline genetic variant in indigenous Peruvian, Colombian, and Mexican ancestry has been identified as a potential contributor to this risk. Other unidentified factors correlated with ancestry proportions in these populations may also be at play.
The review concludes that health inequities persist despite our advancement in understanding the factors that underlie cancer health disparities. A call to eliminate cancer health inequity is made, advocating for the inclusion of more study participants from diverse populations in cancer research, the end of structural violence, and improved access to quality care for underserved groups.1
1. Zavala, V. A., Bracci, P. M., Carethers, J. M., Carvajal-Carmona, L., Coggins, N. B., Cruz- Correa, M. R., Davis, M., de Smith, A. J., Dutil, J., Figueiredo, J. C., Fox, R., Graves, K. D., Gomez, S. L., Llera, A., Neuhausen, S. L., Newman, L., Nguyen, T., Palmer, J. R., Palmer, N. R., … Fejerman, L. (2020). Cancer health disparities in racial/ethnic minorities in the United States. British Journal of Cancer, 1–3. https://doi.org/10.1038/s41416-020-01038-6