By Jonathan Villena-Vargas
08 Oct 2024, 08:00 AM EDT
In recent decades our knowledge about the prevention, detection and treatment of cancer has increased.Yo As a researcher and oncology doctor, I can safely say that we continue to make progress every day, but there are still many problems to be solved. An example: Hispanic men and women in the US have a lower incidence of cancer than non-Hispanic whitesii and yet they are more likely to be diagnosed at an advanced stage of many types of cancer and have a lower five-year survival rate after diagnosis.iii
As the son of Peruvian immigrants who were health care providers, I realized at an early age how differences in income, education, and other socioeconomic factors within our community could contribute to a disproportionate health burden.ii As a thoracic surgical oncologist and through my volunteer work with the American Cancer Society, I have seen the devastating impact that cancer disparities can have on people of Hispanic descent living in the US.ii I have dedicated part of my career to studying socioeconomic barriers in underserved populations such as Hispanic and Latino communities, as well as researching ethnic differences, in order to address these disparities.
In the United States, our community’s lower socioeconomic status stems from certain systemic disadvantages, and has led to inequalities in housing, employment, income, and access to quality health care.ii Compared to non-Hispanic whites, Hispanics are more likely to live in poverty and have limited access to health careiii and health insurance.ii Additionally, these communities are more likely to face stigmatization in healthcare settings, believe that their health outcomes are not within their control, and sacrifice self-care to serve others.iv Cultural differences have significant implications when it comes to preventive care for cancers that are detectable early through screening, such as breast and prostate cancer, the two most common types of cancer in women and men, respectively. .iv Hispanic women are less likely to have mammogramsv and are more likely to be diagnosed with breast cancer at a more advanced stage.ii Similarly, Hispanic men are less likely to be screened for prostate cancer and more likely to be diagnosed at an advanced stage of the disease.ii
Socioeconomic barriers can also limit awareness and access to participation in clinical trials working to advance potentially revolutionary new cancer medications.I saw Most clinical trials are not diverse; According to recently published data, only about 3-6% of participants in cancer clinical trials are Hispanic.viii In addition to lack of insurance and low income, language barriers are also a key contributing factor to low clinical trial participation among our community.I saw Recognizing and addressing these barriers is essential to better understand the safety and effectiveness of cancer treatments in minority populations.viii
As a physician and advocate, I know that the healthcare community must do more to understand and address the social and cultural barriers that prevent optimal care, we must improve communication with our patients and be proactive in creating a plan that has take into account your specific needs. To close the gaps in cancer care and allow people of all races, ethnicities, and socioeconomic backgrounds to benefit from advances in screening and treatment, these barriers must be addressed. And despite the complexities, I believe we can find solutions by working together across industry, patient advocacy groups, governments and other important partners. We must face these challenges together, with a shared mission.
To this end, the American Cancer Society and Pfizer have partnered to launch “Change the Odds: Uniting to Improve Cancer Outcomes?”, a new initiative to begin generating changes where they are most urgently needed: in the communities affected by cancer. disproportionately for breast and prostate cancer due to socioeconomic disparities.iv With $15 million in funding from Pfizer, the initiative aims to raise awareness about free and low-cost screening, improve access to support services, navigation, and provide general information about clinical trials, including culturally and linguistically diverse resources. .
By acting now and together, we can empower our community to access the care we deserve, close the health equity gap, and ultimately improve and save lives. For more information about the initiative and community-focused resources, visit www.cancer.org/ChangeTheOdds
Yo Lukong KE. Understanding breast cancer – The long and winding road. BBA Clin. 2017;7:64-77. doi: 10.1016/j.bbacli.2017.01.00
ii American Cancer Society. Cancer Facts & Figures for Hispanic/Latino People 2021-2023. https://www.cancer.org/content/dam/cancer-org/research/cancer-facts-and-statistics/cancer-facts-and-figures-for-hispanics-and-latinos/hispanic-latino-2021- 2023-cancer-facts-and-figures.pdf
iii Miller KD, Ortiz AP, Pinheiro PS, et al. Cancer statistics for the US Hispanic/Latino population, CA Cancer J Clin. 2021;71(6):466-487. doi:10.3322/caac.21695
iv Siegel RL, Giaquinto AN, Jemal A. Cancer statistics, 2024. CA Cancer J Clin. 2024;74(1):12-49. doi:10.3322/caac.21820
v Shoemaker ML, White MC. Breast and cervical cancer screening among Hispanic subgroups in the USA: estimates from the National Health Interview Survey 2008, 2010, and 2013. Cancer Causes Control. 2016;27(3):453-457. doi:10.1007/s10552-016-0718-5
I saw Duma N, Vera Aguilera J, Paludo J, et al. Representation of minorities and women in oncology clinical trials: Review of the past 14 years. J Oncol Pract. 2018;14(1):e1-e10. doi:10.1200/JOP.2017.025288
viii Oyer RA, Hurley P, Boehmer L, et al. Increasing racial and ethnic diversity in cancer clinical trials: An American Society of Clinical Oncology and Association of Community Cancer Centers joint research statement. J Clin Oncol. 2022;40(19):2163-2171. doi:10.1200/JCO.22.00754
viii National Institute on Minority Health and Health Disparities. Diversity and Inclusion in Clinical Trials. Last reviewed January 12, 2024. Accessed September 12, 2024