J Natl Med Assoc
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Addressing disparities in cancer care and incorporating precision medicine for minority populations.
Cancer incidence and outcomes vary considerably between racial and ethnic groups. Non-Hispanic (NH) Blacks are disproportionately burdened with the most common cancer types, having the highest death rate of any group. Racial health disparities are complex and have been identified at each step of the cancer care continuum, encompassing patient and provider factors and health care system processes. ⋯ Non-clinical factors such as structural racism and lower socioeconomic status are associated with unequal access to resources such as housing, healthy foods, employment, and education, which have been demonstrated to drive racial disparities in cancer. Concerted efforts to understand and target the causes of the observed differences in access, screening, and treatment utilization will be critical for achieving more equitable treatment delivery and outcomes for all patients with cancer. Moreover, ongoing efforts to enhance diversity in clinical trials enrollment and access to novel precision medicine initiatives are processes warranted to reduce healthcare inequalities.
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Despite substantial advances in early detection/prevention and treatments, and improved outcomes in recent decades, prostate cancer continues to disproportionately affect Black men and is the secondleading cause of cancer death in this subgroup. Black men are substantially more likely to develop prostate cancer and are twice as likely to die from the disease compared with White men. ⋯ The underlying causes of these inequalities are complex and multifactorial and involve biological factors, structural determinants of equity (i.e., public policy, structural and systemic racism, economic policy), social determinants of health (including income, education, and insurance status, neighborhood/physical environment, community/social context, and geography), and health care factors. The objective of this article is to review the sources of racial disparities in prostate cancer and to propose actionable recommendations to help address these inequities and narrow the racial gap.