Why We Do

Cancer health disparities are one of the foremost public health challenges in the United States. Racial and ethnic minority populations are among the most vulnerable U.S. population groups experiencing severe disparities when it comes to treatment for cancer. Although there has been some success in reducing cancer incidence and health disparities, the overall cancer death rates among racial and ethnic groups are less pronounced now than they have been in the past two decades.

Disparities exist along the entire paradigm of cancer care in the US. From exposure to preventable cancer risk factors, rates of cancer screening for early detection, implementation of precision oncology, diagnostic testing, enrollment in clinical trials to receipt of standard of care cancer treatment the burden of the adverse effects of cancer and cancer treatment disproportionately fall on racial and ethnic minorities and the socioeconomically less fortunate, alongside other underserved populations in the United States. In addition, recent focus has identified a major role of multiple social determinants of health (SDoH) adversely impacting cancer outcomes.

Recent studies have identified factors that ultimately lead to cancer health disparities. We have also learnt the complex interplay of these factors. We are also learning about biological and genetic factors’ role in cancer health disparities. Addressing cancer health disparities will require multi-lateral collaboration.

Causes of Disparities

Lack of cancer screening

  • Cancer screening saves lives and reduces total cost of care during the lifetime of beneficiaries
  • 87% of Eligible Seniors Do Not Receive Lung Cancer Screenings: Lung cancer screenings were higher among Medicaid beneficiaries in states that covered the preventive service.
  • Over 7,600 Medicaid beneficiaries—or 15.7 percent—received a screening, leaving approximately 84 percent that did not. Nearly 41,500—or 12.5 percent—of the Medicare beneficiaries received the screening. Over 292,400 Medicare beneficiaries who were eligible for a lung cancer screening—or 87.1 percent of eligible patients—did not get screened.
  • Breast cancer is the most common cancer worldwide and the most common cancer diagnosed in American women. It is second leading cause of cancer death in American women.
  • Even though curable when caught earlier (close to 99%), close to 30% of women did not get mammography for breast cancer between 2017-2019

Despite the fact that many cancer risk factors can be reduced by early detection and intervention, more than 40% cancer cases diagnosed among U.S. adults are attributable to potentially modifiable causes.

Implementation of early detection and intervention by cancer screening is less frequent among racial and ethnic minorities. Therefore, there is an urgent need for new strategies to enhance cancer prevention through early detection, appropriate screening and implementation of evidence-based interventions to reduce the burden of cancer for all populations.

Lack of Access to Clinical Trials

 Minorities are less likely to enroll in studies

Only 5% of participants in Breast and Prostate Cancer prevention trials were minorities

Between 1996 to 2002, the annual number of trial participants increased from 8,000-12,000 while minority participation decreased

Clinical trials are a vital part of the biomedical research cycle because they establish whether or not new cancer treatments are safe and effective for the patients who need them. Therefore, it is imperative that participants in clinical trials that are testing new cancer treatments represent the entire population who may use them if they are approved. Despite this knowledge, participation in cancer clinical trials is low, and there is a serious lack of racial and ethnic diversity among those who do participate. It is imperative that we overcome the many barriers to clinical trial participation if we are to ensure that all segments of the population benefit from progress in the fight against cancer.

Some clinical trials are only available in major cities and require substantial travel for patients; 40% of patients drive more than 60 minutes one way.

Access to care

  • Financial constraints can lead to financial toxicity and abandonment of treatment
  • 19% or 6 million Medicare FFS beneficiaries do not have supplemental coverage
  • Depending on the therapy, the top 10 Medicare Part B‐covered biologics with the highest OOP expenses may:
  • Incur annual OOP costs of approximately $2,500 to $15,000 for 19% of beneficiaries
  • Increasing financial toxicity may result in either noncompliance or abandonment of treatment
  • Annual OOP costs may reach up to approximately 58% of the median per capita income of Medicare beneficiaries in the United States

Impact of Cancer Health Disparities

  • African American men have a 111 % higher risk of dying from prostate cancer compared to white men
  • African Americans have two-fold higher mortality from Multiple Myeloma compared to their age matched pair control Caucasian counterpart3
  • African American women have 39% higher risk of dyingfrom breast cancer compared to white women
  • Men living in the poorest counties in the United States have a colorectal cancer death rate that is 35 percent higher than that for men living in the most affluent counties
  • 34% of cancer deaths can be prevented if we address disparities.
  • Eliminating disparities would have reduced spending by$230 billion between 2003 to 2006 direct medical costs and over a trillion dollars in indirect costs

We're stronger together

As leaders we have the opportunity and the responsibility, to take action on issues that affect employees’ mental well-being, eliminating stigmas and creating a psychologically safe and inclusive workplace. 

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