Cancer healthcare disparities among African Americans in the United States

A need exists to examine racial disparities in the healthcare arena and the impact on patients with cancer. Despite ongoing efforts to increase equity in primary healthcare access, racial and socioeconomic disparities persist, thus contributing to disproportionate treatment outcomes and survivorship among minority and low-income patients. Such disparities have been revealed in treatment cohorts of patients with multiple forms of cancer, including breast, cervical, ovarian, endometrial, prostate, lung, colorectal, gastrointestinal, and hepatocellular, and have been attributed to a range of co-occurring behavioral, social determinants of health, underlying genetic factors, as well as access to educational opportunities that limit the quality of informed healthcare. These various interrelated factors widen cancer healthcare disparities synergistically throughout underserved communities, and their influence has been amplified by the coronavirus disease 2019 (COVID-19) pandemic. Fundamentally, a lack of basic and clinical research exists that fails to adequately reflect diversity and minority involvement in drug development. Although overcoming the obstacles responsible for chronic treatment disparities is a formidable task, promising means of achieving more uniform quality healthcare are becoming more clearly elucidated. To reduce disease progression, increase overall survival, and improve the health of vulnerable populations, it is necessary to identify and fully disclose environmental, biological, and ancestral factors that impact the risk for cancer; heal historical fractures within communities; and increase participation of racial and ethnic minorities in screening efforts and research studies. This requires developing a system of justice and trust based on specific, solution-oriented grassroots community efforts working in tandem with medical and pharmaceutical leaders. By fully exploring and pinpointing the underlying causes of healthcare disparities, it should be possible to define strategies and interventions most likely to transform cancer care. The ultimate goal is understanding individual, cultural, and biological vulnerabilities, including environmental and epigenetic liabilities, to optimize cancer prevention, diagnosis, and treatment.