The Influence of Health Disparities on Targeting Cancer Prevention Efforts

Abstract

Despite the advances in cancer medicine and the resultant 20% decline in cancer death rates for Americans since 1991, there remain distinct cancer health disparities among African Americans, Hispanics, Native Americans, and the those living in poverty. Minorities and the poor continue to bear the disproportionate burden of cancer especially in terms of stage at diagnosis, incidence and mortality. Cancer health disparities are persistent reminders that state-of-the art cancer prevention, diagnosis, and treatment are not equally effective for and accessible to all Americans. The cancer prevention model must take into account the phenotype of accelerated aging associated with health disparities as well as the important interplay of biological and sociocultural factors that lead to disparate health outcomes. The building blocks of this prevention model will include: interdisciplinary prevention modalities that encourage partnerships across medical and nonmedical entities, community-based participatory research, development of ethnically and racially diverse research cohorts, and full actualization of the prevention benefits outlined in the 2010 Patient Protection and Affordable Care Act. However, the most essential facet should be a thoughtful integration of cancer prevention and screening into prevention, screening, and disease management activities for hypertension and diabetes mellitus since these chronic medical illnesses have a substantial prevalence in populations at risk for cancer disparities and cause considerable comorbidity and likely complicate effective treatment and contribute to disproportionate cancer death rates.

Opportunities for Cancer Prevention During Midlife

“…70 Evans defined health disparities as differences in health related to characteristics such as SES, gender, race, ethnicity, and education. Disparities in life expectancy across racial and ethnic groups and SES are widespread and persistent.…”

Impact of Age and Comorbidity on Cervical and Breast Cancer Literacy of African Americans, Latina, and Arab Women

“…This is particularly important for African Americans because they are more likely to have chronic diseases. 114 For example, African Americans have a higher rate of stroke (31%) and heart disease (23%) than Whites. 115 …”

Forging an Integrated Agenda for Primary Cancer Prevention During Midlife

“…Also, decreases in physical activity and insomnia are known to be more pronounced in midlife and older adulthood, 13,14 which would negatively affect biology (biological/genetics pathway level) and perhaps increase the use of health care (institutions level). Zonderman et al 24 caution that factors during midlife may vary across race/ethnicity and SES, and Muirhead 25 suggests that it also might present unique challenges to adults with serious mental illness.…”