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Charting the Future of Cancer Health Disparities Research
Leading national cancer organizations have released a joint
position statement to guide the future of cancer health disparities research.
The statement represents a unified strategy by the American Association for
Cancer Research (AACR), the American Cancer Society (ACS), the American Society
of Clinical Oncology (ASCO), and the National Cancer Institute (NCI) to foster
cooperation across the cancer research community to ensure that all patients –
regardless of social demographics, socioeconomic status, or the communities in
which they live – benefit from cancer research.
“The AACR is committed to eliminating cancer health
disparities, and we hope that the recommendations put forward through this
unprecedented collaboration will promote cooperation among all stakeholders in
the cancer disparities research community to ensure that research-driven
advances benefit all patients, regardless of their race, ethnicity, age,
gender, socioeconomic status, and community in which they live,” said Margaret
Foti, PhD, MD (hc), chief executive officer of the AACR.
According to the statement, cancer health disparities are
pronounced and well documented. Medically underserved populations, including
racial and ethnic minorities and individuals of lower socioeconomic status, experience
worse cancer outcomes. As the organizations discuss, disparities are driven by
a range of multilevel patient, community, and structural factors, including
sociodemographics, health care access, lifestyle factors, and biological and
genetic differences. While understanding of underlying causes of cancer
disparities is growing, emerging and increasing cancer disparities among some
populations continue to create new challenges – requiring a deeper
understanding of the multilevel, interrelated causes and how to effectively
address them, according to the organizations.
The position statement was developed following a summit held
by the groups, which brought together experts in clinical cancer research,
epidemiology, public health, and health care policy, as well as patient
advocates, to discuss the current state of cancer health disparities research
and identify top priorities in the field.
Research Needs and Priorities
The joint statement, published simultaneously today by
the four co-authoring organizations, outlines the following top research needs
Defining and improving data measures and tools for cancer
disparities research: Patient data are often incomplete, inaccurate, or
overly-simplified and usually do not consider many social and community
factors. Cancer disparities research is limited by a lack of comprehensive,
consistent data on factors that impact disparities in cancer care and patient
outcomes, including a patient’s social status and demographics, community and
lifestyle factors, and biology and genetics, as well as by widespread variation
in data collection methodology.
Addressing disparities in cancer incidence:
Eliminating disparities in cancer incidence requires advancing knowledge of
biological and environmental determinants of cancer incidence disparities,
including a greater understanding of the role of genetics in contributing to
higher cancer risk among certain populations.
Addressing cancer survival disparities: Currently,
the interplay between system-level, biological, social, and environmental
factors is often inadequately accounted for in cancer research. Counteracting
growing disparities in cancer survival requires a more complete picture of the
range of factors involved and how to track, identify, and address them.
Improving community engagement in cancer research:
Poor translation of innovation in cancer care into health care systems in
diverse communities has hampered the impact of innovative treatments and
precision medicine advances on underserved patient populations. Ensuring that
all patient populations benefit from advances in cancer care requires stronger
community engagement in cancer research.
Redesigning cancer clinical trials to acknowledge and
address cancer disparities: Recruitment and retention rates in cancer
clinical trials are lower for some patient populations. Since clinical trials
are the foremost means of generating reliable evidence on efficacy of
treatments and patient care methods, changes to the clinical trials system are
needed to improve the generalizability and applicability of clinical trial
findings and better inform the care of underrepresented patient groups.
The statement provides a series of recommendations to
address each of these outlined needs, with a particular focus on guiding
investments in cancer health disparities research. In addition to specific
recommendations in each of these areas, the statement also includes broad
action items that can be taken to further the field of cancer research
disparities as a whole, based on the current landscape and existing
Investigators, research sponsors, and research publications
should insist on the use of the highest-quality data measurement tools and the
most granular data for conducting cancer disparities research.
Establishment of a health disparities research network and
multiple consortia to gather relevant patient contextual data and biospecimens
are needed to effectively inform cancer disparities research that examines the
multilevel factors involved in causing cancer disparities.
Best practice strategies should be designed and utilized to
engage underserved populations in research studies and ensure they are informed
of clinical trial opportunities.
Researchers should be adequately trained in community
engagement research tactics, and academic promotions should appropriately
account for time needed to conduct community engagement research. Expectations
for the possible need for funding beyond funding cycles should be made for
community engagement research.
Cancer treatment systems should ensure real-time monitoring
of patient experiences to understand how patients are being treated and
intervene when care and outcomes disparities are identified.
“Charting the Future of Cancer Health Disparities
Research: A Position Statement from the American Association for Cancer
Research, the American Cancer Society, the American Society of Clinical
Oncology, and the National Cancer Institute,” was published July 24
in Cancer Research.
This joint statement is the latest example of the AACR’s
longstanding commitment to addressing cancer health disparities, often in
association with the AACR Minorities in Cancer Research Council (MICR). In
September, the AACR and MICR will host the 10th AACR Conference on the Science of Cancer Health Disparities
in Racial/Ethnic Minorities and the Medically Underserved in
Atlanta. Learn more about the AACR and MICR’s work in this area.