The Cancer Disparities Progress Report 2024, released by the American Association for Cancer Research (AACR), highlights the urgent need for sustained action to address the significant disparities in cancer mortality among black, Indigenous, and other minority populations in the U.S. It's crucial to prioritize and support these communities in overcoming these challenges.

First published in 2020, this biennial report is raising awareness about the huge impact cancer has on racial and ethnic minority groups and other underserved populations in the U.S.

Highlighting the reasons behind cancer disparities and showing promising trends in reducing these inequities, the report is also stressing the importance of continuous research and collaborations to ensure that advancements in cancer treatment benefit everyone, regardless of race, ethnicity, age, sexual orientation, gender identity, socioeconomic status, or geographic location.

Containing nine personal stories from cancer survivors of different backgrounds, which show the critical need for funding cancer research and passing laws to achieve health equity, which is a basic human right, the report stresses that by addressing the systemic and social factors that contribute to these disparities and by implementing targeted policies and research efforts, one can move towards a more equitable healthcare system that ensures all individuals have the opportunity to achieve the best possible cancer outcomes.

Acknowledging that the overall cancer death rate in the U.S. has fallen by 33% between 1991 and 2020 due to advances in prevention, early detection, and treatment, the report points out that these advances are not benefiting everyone equally.

The authors argue that a long history of racism, segregation, and discrimination against marginalised groups in the U.S. has caused structural inequalities and systemic injustices that harm human health.

Moreover, the lack of diversity in the cancer research and care workforce, due to the same institutional and societal injustices that limit educational opportunities for minoritized communities, also contributes to these health inequities, they add.

Stressing that many segments of the U.S. population are bearing a disproportionate cancer burden, the AACR Cancer Disparities Progress Report 2024 notes that although the overall cancer incidence rates among black and Indigenous populations are lower compared to the white population, black and Indigenous individuals have the highest overall cancer death rates of all U.S. racial or ethnic groups.

"This disparity is especially stark in the black community," the report notes.

To substantiate their argument, the authors of the report point out that black men are twice as likely to die from prostate cancer compared to their white counterparts.

Furthermore, although the incidence of breast cancer is similar in black and white women, black women are 40% more likely to die from it.

Similarly, black people in the US are twice as likely to be diagnosed with and die from multiple myeloma.

The authors further point out that American Indian or Alaska Native, Asian and Pacific Islander, and Hispanic people are more than twice as likely to die from stomach cancer compared to their white counterparts. These groups also face higher rates of liver cancer.

Interestingly, the report points out that lung cancer incidence is increasing among Asian women who have never smoked.

Similarly, residents of nonmetropolitan or rural counties are 38% more likely to be diagnosed with and die from lung cancer compared to those living in large metropolitan or urban areas.

The report further notes that sexual and gender minorities also experience notable disparities, and to substantiate their argument, the authors of the report note that the risk of breast cancer is higher among sexual minority women compared to heterosexual women.

Transgender individuals are at a 76% higher risk of being diagnosed with advanced-stage lung cancer compared to cisgender individuals.

While transgender women seem to be at a 60% lower risk of developing prostate cancer compared to cisgender men, their likelihood of dying from it is nearly double.

The report explores the roots of cancer disparities and the many complex reasons they persist. Social drivers of health (SDOH), such as education, income, employment, housing, transportation, and access to healthy food, clean air, water, and health care services, are major contributors to cancer disparities among racial and ethnic minority groups and medically underserved populations. For example, an analysis of U.S. cancer deaths in the context of residential segregation caused by decades of redlining found that during 2015–2019, residents of disadvantaged neighbourhoods had a 22% higher mortality rate for all cancers compared to those in advantaged neighbourhoods not historically subjected to redlining.

Additionally, ancestry-related biological factors—such as differences in genetic variants, epigenetic alterations, immune profiles, and microbiomes—may lead to disparities between different populations. Therefore, the report emphasises a comprehensive approach that considers the interplay of environmental exposures, life experiences, and biology in mediating cancer risks.

The lack of diversity in existing cancer genomics datasets, the underrepresentation of minority groups in clinical trials, and the lack of diversity in STEMM educational and career pathways, specifically in the cancer research and care workforce, are other major contributing factors to cancer disparities discussed in the report.

Pointing out that despite the ongoing challenges, some progress has been made against cancer disparities. The AACR Cancer Disparities Progress Report 2024 highlights significant reductions in cancer mortality disparities between black and white populations, decreasing from 33% in 1990 to 11.3% in 2020. Additionally, cancer-specific mortality rate disparities have lessened for lung cancer between white and black men, cervical cancer between white and Hispanic women, and stomach cancer between white and Asian and Pacific Islander populations.

The report urges policymakers and stakeholders to enhance funding for U.S. federal agencies and initiatives aimed at eradicating cancer inequalities. It also recommends multiple proactive steps, including supporting data-gathering programmes to reduce cancer disparities, increasing access to and participation in clinical trials, prioritising cancer control measures, and boosting screening for early detection and prevention. Additionally, it calls for implementing policies to ensure equitable patient care, promoting diversity and inclusivity in the cancer research and care workforce, and enacting comprehensive legislation to eliminate health disparities.

“We are very proud to release the third edition of the AACR Cancer Disparities Progress Report,” said Dr Margaret Foti, chief executive officer of AACR in a statement. 

“In this era of extraordinary scientific progress against cancer, it is crucial that we ensure that no populations or communities are left behind. Health equity is a fundamental human right and must be a national priority. We hope that the information and recommendations in this report will inspire collaboration among stakeholders and the necessary support from Congress to tackle these complex issues and eliminate cancer disparities once and for all,” she added.