In the United States, well-documented racial and ethnic inequities persist in cancer
treatment and outcomes.
1
,2
These disparities exist across the continuum of cancer care, culminating in later
stages at diagnosis, need for more comprehensive therapy, and worse mortality among
Black patients compared to White patients.
1
,2
Notably, Black individuals with cancer have not equally benefitted from advances
in contemporary oncology care, and in breast cancer specifically, the Black-White
survival gap has worsened over time.
1
,2
Contributors to cancer disparities are multifactorial and include: (i) barriers to
access in screening and treatment; (ii) bias in cancer care delivery; and, (iii) sociodemographic
differences in environment (i.e; allostatic load), genomics, health behavior, and
literacy.
3
The complexity of health disparities and longstanding cultural injustices result
in modern patterns of inequitable care that are not simple to disentangle and even
more challenging to resolve.
4
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References
- Health disparities and cancer: racial disparities in cancer mortality in the United States, 2000-2010.Front Public Health. 2015; 3: 51
- Lack of reduction in racial disparities in cancer-specific mortality over a 20-year period.Cancer. 2014; 120: 1532-1539
- Disparities in breast cancer treatment and outcomes: biological, social, and health system determinants and opportunities for research.Oncol. 2013; 18: 986-993
- Structural racism and health inequities in the USA: evidence and interventions.Lancet. 2017; 389
- Disparities in timely treatment among young women with breast cancer.Am J Surg. 2022; 224: 811-815
- Time to surgery and breast cancer survival in the United States.JAMA Oncol. 2016; 2: 330-339
- Biology of breast cancer in young women.Breast Cancer Res. 2014; 16
- Differences in breast cancer incidence among young women aged 20-49 years by stage and tumor characteristics, age, race, and ethnicity, 2004-2013.Breast Cancer Res Treat. 2018; 169: 595-606
- Time to surgery among women treated with neoadjuvant systemic therapy and upfront surgery for breast cancer.Breast Cancer Res Treat. 2021; 186: 535-550
- Adjuvant capecitabine for breast cancer after preoperative chemotherapy.N Engl J Med. 2017; 376: 2147-2159
- Trastuzumab emtansine for residual invasive HER2-positive breast cancer.N Engl J Med. 2019; 380: 617-628
Article info
Publication history
Published online: May 20, 2022
Accepted:
May 7,
2022
Received in revised form:
May 6,
2022
Received:
April 26,
2022
Identification
Copyright
© 2022 Published by Elsevier Inc.
