Racial Health Disparity in Cancer: Assessments of Need

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Background

Overall, health inequity, health inequality, and health disparity exist in every aspect of our healthcare system. In the context of cancer, health inequity, health inequality, and health disparity span the cancer control continuum, including prevention, early detection, diagnosis, treatment, survivorship, and end-of-life care. The result of these health inequities, health inequalities, and health disparities are observed differences in cancer incidence, aggressiveness, response to therapy, and mortality among patients of different racial and ethnic groups. Among racial and ethnic groups, we are aware that African American patients have the highest mortality rate and shortest survival for most cancers. While cancer incidence rates are lower for Hispanics, this population presents with cancer at a younger age and tumors are often more aggressive in Hispanic patients. Despite these facts, racial and ethnic disparities in translational and clinical cancer research exist, with patients of color being underrepresented in genomic projects and clinical trials.

We have moved into an era where most physicians define racial health disparity mainly in terms of access to care and compliance. This does a disservice to encouraging holistic efforts to define health disparity in terms of individual-level (e.g. ancestry-related genomics and physiology), societal-level (e.g. racism and discrimination), neighborhood-level (e.g. diet, environment), and institutional-level (e.g. access to care) factors, which are all determinants of health disparities. There is an urgent need for increased translational and clinical research focused on how each of these determinants of health contributes to racial and ethnic disparities in cancer incidence, aggressiveness, response to therapy, and mortality as well as how the complex interplay among all of these determinants of health contribute to these racial and ethnic cancer disparities. What indeed is extremely important toward mitigating cancer inequities, inequalities, and disparities and achieving cancer health equity for all is a more concerted effort to provide translational and clinical research data generated using diverse in vitro, ex vivo, and in vivo models. It is imperative that documented peer-reviewed research be inclusive of all world populations. Herein, through this focused Research Topic, we propose to detail, highlight, and suggest strategies to address this dearth of information.

The theme of this Research Topic is cancer racial/ethnic disparity. We aim to generate a publication that will provide in one site a review of what has been reported to date and unpublished cutting-edge research focused on differences in cancer incidence, aggressiveness, and mortality as well as differences in responses to cancer therapies among different cancer patient populations. We will include individual-, societal-, neighborhood-, and institutional-level determinants of health. Our overview and future directions sections will provide our vision of the urgent needs in the field and potential approaches to address them.


Please note: manuscripts consisting solely of bioinformatics, computational analysis, or predictions of public databases which are not accompanied by validation (independent cohort or biological validation in vitro or in vivo) will not be accepted in any of the sections of Frontiers in Oncology.

Keywords: Epigenetic, Admixture, Health Disparity, Health Inequality, Health Inequity, Social determinate of Health, Chemoresponse, Chemotherapy, Chemoresistance, Tumor Biology

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