ANTI-CANCER

Cancer is a significant public health concern worldwide, affecting individuals and families from all population groups. However, due to social, environmental, and economic disadvantages, certain groups bear a disproportionate burden of cancer compared with other groups. These disparities in cancer incidence, mortality, and outcomes are known as cancer disparities or cancer health disparities. In this article, we will discuss cancer disparities in the United States, including the groups that are most affected and the impact of these disparities on cancer prevention, detection, and treatment.

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Types of Cancer Disparities
Cancer disparities can be seen in many measures of cancer, including incidence (new cases), prevalence (all existing cases), mortality (deaths), survival (how long people survive after diagnosis), morbidity (cancer-related health complications), survivorship (including quality of life after cancer treatment), financial burden of cancer or related health conditions, and screening rates. Disparities can also be seen when overall outcomes are improving, but the improvements are not seen in some groups relative to other groups.

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Groups Affected by Cancer Disparities
Population groups that may experience cancer disparities include groups defined by race/ethnicity, disability, gender identity, geographic location, income, education, age, sexual orientation, national origin, and/or other characteristics. These groups may face barriers to cancer prevention, detection, and treatment, such as lack of access to healthcare, inadequate insurance coverage, cultural and linguistic barriers, and lack of awareness about cancer prevention and screening.

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Race/Ethnicity
One of the most significant contributors to cancer disparities is race/ethnicity. For example, African Americans have higher cancer incidence and mortality rates than other racial and ethnic groups for many types of cancer, including prostate, breast, lung, and colorectal cancer. Hispanic/Latino individuals have higher rates of liver and stomach cancer, while Asian Americans have higher rates of liver, stomach, and cervical cancer. Native Hawaiians and Pacific Islanders have higher rates of liver and lung cancer, and American Indians and Alaska Natives have higher rates of liver, stomach, and cervical cancer.

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Disability
Individuals with disabilities may also experience cancer disparities, as they may face barriers to accessing cancer prevention, detection, and treatment services. For example, they may have difficulty accessing transportation to medical appointments, physical barriers to healthcare facilities, and communication barriers with healthcare providers. They may also be more likely to experience poverty, which can further exacerbate cancer disparities.

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Gender Identity and Sexual Orientation
Individuals who identify as LGBTQ+ may also face cancer disparities, including higher rates of certain types of cancer, such as anal and cervical cancer. They may also face barriers to accessing cancer prevention and screening services, such as lack of insurance coverage, discrimination from healthcare providers, and fear of stigma or discrimination.

Geographic Location
Geographic location can also be a factor in cancer disparities, as individuals living in rural or remote areas may have limited access to cancer prevention, detection, and treatment services. They may need to travel long distances to reach healthcare facilities, and healthcare providers may be in short supply. Rural residents may also be more likely to engage in behaviors that increase cancer risk, such as tobacco use and physical inactivity.

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Income and Education
Individuals with lower income and education levels may also experience cancer disparities, as they may have limited access to healthcare services and cancer prevention and screening programs. They may also face barriers to adopting healthy behaviors, such as healthy eating and physical activity, due to cost and lack of access to healthy foods and safe places to exercise.

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Measures of Cancer
Cancer disparities are a significant public health concern, with certain groups bearing a disproportionate burden of cancer compared with other groups. These disparities can be seen in many measures of cancer, including incidence, mortality, and outcomes. Population groups that may experience cancer disparities include groups defined by race/ethnicity, disability, gender identity, geographic location, income, education, age, sexual orientation, national origin, and/or other characteristics. Addressing cancer disparities will require a multi-faceted approach, including increased access to healthcare services, cancer prevention and screening programs, and education and awareness campaigns. ​

Solutions ? 

Despite overall declines in cancer incidence and mortality rates, certain groups continue to be at increased risk of developing or dying from particular types of cancer. These disparities in cancer incidence, mortality, and outcomes are known as cancer disparities, and they reflect the complex interplay among social determinants of health, behavior, biology, and genetics.

Certain population groups in the world experience cancer disparities because they are more likely to encounter obstacles in getting health care. For example, people with low incomes, low health literacy, long travel distances to screening sites, or who lack health insurance, transportation to a medical facility, or paid medical leave are less likely to have recommended cancer screening tests and to be treated according to guidelines than those who do not encounter these obstacles. People who do not have reliable access to health care are also more likely to be diagnosed with late-stage cancer that might have been treated more effectively if diagnosed at an earlier stage.

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Environmental conditions can also contribute to cancer disparities. People who live in communities that lack clean water or air may be exposed to cancer-causing substances. The built environment can also influence behaviors that raise one's risk of cancer. For example, people who live in neighborhoods that lack affordable healthy foods or safe areas for exercise are more likely to have poor diets, be physically inactive, and obese, all of which are risk factors for cancer.

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Even people of higher socioeconomic status and those with health insurance may experience cancer disparities. The disparities these individuals experience may reflect the health impact of institutional racism and the chronic stress it causes, conscious or unconscious bias from health providers, mistrust of the health care system, and/or fatalistic attitudes about cancer.

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Inherited factors or tumor biological factors may also contribute to cancer disparities. For example, some evidence suggests that there are differences in the genetics, tumor biology, and immune environment of triple-negative breast, colorectal, and prostate cancers that arise in African Americans compared with those that arise in people of other racial/ethnic groups. These differences may contribute to disparities in incidence, aggressiveness, and response to treatment of these cancers.

Cancer disparities have significant consequences for individuals, families, and society as a whole. Disparities in cancer incidence and mortality rates can result in premature deaths, lost productivity, and increased health care costs. These disparities can also exacerbate social and economic inequalities, as certain population groups may experience reduced access to education, employment, and other opportunities due to the burden of cancer.

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In addition to the physical and economic consequences of cancer disparities, there are also significant psychological and emotional consequences. Cancer diagnosis and treatment can be stressful and traumatic, and cancer disparities can exacerbate the psychological burden of cancer. People who experience cancer disparities may feel a sense of injustice, anger, frustration, and hopelessness, which can negatively impact their mental and emotional well-being.

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Solutions to Address Cancer Disparities
Addressing cancer disparities will require a multi-faceted approach, including increased access to healthcare services, cancer prevention and screening programs, and education and awareness campaigns. Policy changes will also be necessary to overcome systemic social, racial, and institutional inequalities. Improving access to healthcare services is critical to reducing cancer disparities. This can include expanding health insurance coverage, increasing the number of healthcare providers in underserved areas, and improving transportation options for patients who live far from healthcare facilities. Providing culturally and linguistically appropriate care is also important, as this can help to overcome communication barriers and improve trust between patients and healthcare providers.

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Increasing cancer prevention and screening programs can also help to reduce cancer disparities. This can include targeted campaigns to increase screening rates among population groups that are at increased risk of developing certain types of cancer. Education and awareness campaigns can also help to increase knowledge about cancer prevention and screening, as well as reduce stigma and fear associated with cancer.

Improving diversity in clinical research participation is also important to address cancer disparities. This can help to ensure that research results are applicable to all populations and can help to identify factors that contribute to cancer disparities. These disparities reflect the complex interplay among social determinants of health, behavior, biology, and genetics. Addressing cancer disparities will require a multi-faceted approach, including increased access to healthcare services, cancer prevention and screening programs, education and awareness campaigns, and policy changes to overcome systemic social, racial, and institutional inequalities. By working to address cancer disparities, we can improve cancer outcomes for all individuals in the world.