American Cancer Society's report on the status of cancer disparities in the United States, 2021

Abstract

In this report, the authors provide comprehensive and up‐to‐date US data on disparities in cancer occurrence, major risk factors, and access to and utilization of preventive measures and screening by sociodemographic characteristics. They also review programs and resources that have reduced cancer disparities and provide policy recommendations to further mitigate these inequalities. The overall cancer death rate is 19% higher among Black males than among White males. Black females also have a 12% higher overall cancer death rate than their White counterparts despite having an 8% lower incidence rate. There are also substantial variations in death rates for specific cancer types and in stage at diagnosis, survival, exposure to risk factors, and receipt of preventive measures and screening by race/ethnicity, socioeconomic status, and geographic location. For example, kidney cancer death rates by sex among American Indian/Alaska Native people are ≥64% higher than the corresponding rates in each of the other racial/ethnic groups, and the 5‐year relative survival for all cancers combined is 14% lower among residents of poorer counties than among residents of more affluent counties. Broad and equitable implementation of evidence‐based interventions, such as increasing health insurance coverage through Medicaid expansion or other initiatives, could substantially reduce cancer disparities. However, progress will require not only equitable local, state, and federal policies but also broad interdisciplinary engagement to elevate and address fundamental social inequities and longstanding systemic racism.

Gender, Age, Racial and Ethnic Disparities in Clinical Trial Enrollment for Primary Liver Cancer

“…[2][3][4][5] For example, Black, Hispanic, and Asian persons have higher age-adjusted PLC incidence rates compared with White persons, with the fastest increases observed in American Indian/Alaskan Native and Hispanic persons. 6,7 Disparities in tumor stage at diagnosis, curative treatment receipt, and prognosis have also been consistently demonstrated, with Black patients having worse overall survival and Hispanic and Asian patients having better overall survival compared with White patients. 5 Although there have been tremendous recent advances in PLC locoregional and systemic therapies, diversity of trial participants has not been investigated.…”

Trends in Cancer Mortality Among Black Individuals in the US From 1999 to 2019

“…1 Despite annual decreases in cancer mortality, death rates among Black individuals remain higher than in other racial and ethnic groups. 2 Detailed understanding of cancer mortality trends among Black individuals is essential to assess recent progress and to inform interventions aimed at addressing disparities. Therefore, we assessed trends in cancer mortality rates from 1999 to 2019 among Black adults by cancer site, age, and sex and compared cancer mortality rates in 2019 among Black men and women with rates in other racial and ethnic groups.…”

A Scoping Review of Strategies to Increase Black Enrollment and Retention in Cancer Clinical Trials

“…2 Among Black populations in the United States, lung, prostate, multiple myeloma, and colorectal cancer have both higher rates of incidence and mortality rates when compared with non-Hispanic Whites. 3 Complicating these trends is the low recruitment and retention of Black participants in cancer clinical trials (CCTs), [4][5][6] which adversely affect the generalizability of promising therapies to those with higher risk and poorer prognosis. Although considerable efforts have been made to increase the diversity of CCT participants, only 10% of study participants in National Cancer Institute (NCI) trials are of a minority racial or ethnic background.…”