Continued advances in cancer research, detection, and treatment have resulted in a decline in both incidence and death rates for all cancers. Among people who develop cancer, more than half will be alive in 5 years, yet cancer remains a leading cause of death in the United States, second only to heart disease. Cancer affects all population groups in the United States. But certain groups may bear a disproportionate burden of cancer compared with other groups.
Cancer disparities (sometimes called cancer health disparities) are differences in cancer measures such as:
- incidence (new cases)
- prevalence (all existing cases)
- mortality (deaths)
- morbidity (cancer-related health complications)
- survivorship, including quality of life after cancer treatment
- burden of cancer or related health conditions
- screening rates
- stage at diagnosis
Cancer disparities can also be seen when outcomes are improving overall but the improvements are delayed in some groups relative to other groups. Although disparities are often considered in the context of race/ethnicity, other population groups may experience cancer disparities. These include groups defined by disability, gender/sexual identity, geographic location, income, education, and other characteristics.
LGBTQ Cancer Disparities
A survey of oncologists finds that most say they don’t know enough about how to treat people in the lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ) community, but want to learn more. The study was led by researchers from the NYU School of Medicine and Moffitt Cancer Center and was published January 16, 2019 in the Journal of Clinical Oncology.
The survey was designed to measure attitudes and knowledge about LGBTQ health issues. Authors of the study say this is the first survey of its kind. It was sent to 450 oncologists from 45 large cancer centers in the US, and 149 of them answered. More than half of those who answered (65.8%) said knowing the gender identity of patients is important, but less than half (39.6%) agreed that knowing the sexual orientation of patients is important. Most (70.4%) said they were interested in learning more about the unique health needs of LGBTQ patients. Two of the world’s most prolific cancer research and treatment organizations recognized for diversity and inclusion are Moffitt Cancer Center and Cleveland Clinic.
Moffitt Cancer Center and Research Institute – LGBTQ Cultural Competence Training
Utilizing the information gathered in the survey, Moffitt researchers teamed with Sylvester Comprehensive Cancer Center at the University of Miami and UF Health Cancer Center at the University of Florida to create an online cultural competency training program to improve knowledge of LGBTQ – related issues among the cancer care community. The Curriculum for Oncologists on LGBTQ populations to Optimize Relevance and Skills, or COLORS Training Program for short, contains four 30-minute modules. Two modules cover general topics, such as sexual orientation and gender identity. The remaining two modules discuss oncology-focused topics, including fertility and hormone therapy for LGBTQ patients undergoing cancer treatment.
Moffitt Cancer Center also focuses its efforts to conduct research addressing racial disparities in cancer by establishing a community support initiative created in memory of a local African-American iconic Judge George Edgecomb.
Cleveland Clinic – Cancer Disparities Symposium
Last month Cleveland Clinic hosted its’ 3rd Annual Cancer Disparities Symposium; “Eliminating Cancer Disparities: Staying the Course Toward Collective Impact.” The Cancer Disparities Symposium served to educate, motivate and inspire the over 200 people in attendance, including; researchers, clinicians, health professionals, community outreach teams, patient advocates, trainees and key stakeholders from community-based organizations, local government, private foundations and commercial businesses – representing seven states. The focus was on the current landscape of cancer disparities research across the continuum, from basic, clinical and community science. There were many highlights from this year’s symposium that are encouraging for reducing cancer health disparities.
Cancer Research Innovations
In an effort to learn more about cancer research and health equity, last Saturday I attended the Coming Together Against Cancer (CTAC) event conducted in Sarasota, FL. It was a wonderful opportunity to learn first-hand about the latest cancer research from the eight pioneering physicians leading the innovative effort, and ask the doctors questions about their research and personally interact with the pioneering physicians.
Of particular interest to me were the insights shared by Susan J. Hoover, MD Associate Professor of Surgery, Breast Surgical Oncology and Stephen Rosenberg, MD Radiation Oncology of Moffitt Cancer Center and Research Institute during the panel discussion.
I gained an understanding of several targeted treatments and recent research developments, including:
- Combining radiation treatment with MRI guidance: Radiation Treatment with MRI Guidance provides the ability to see tumors in real time, avoid normal organs and adapt radiation treatment to appropriately and precisely target cancer. This technology can see in real time and adjust radiation therapy—a form of precision and personalization of medicine, which we did not have before. Rather than target a cancer mutation, we can use the patient’s anatomy to better target their tumor and deliver radiation dose.
- Using artificial Intelligence pathways: in the future, Moffitt hopes to use artificial intelligence pathways to look at imaging, identify areas of resistance or sensitivity to treatment instead of one homogeneous dose. Rather than target a mutation of cancer, use the patient’s anatomy in real time to better target the tumor and deliver the radiation dose to improve patient outcomes.
- Improving breast cancer survival: better screening, advanced 3D technology enables earlier detection which translates to better survival rates. In the future, Moffitt anticipates breakthroughs with focus on the immune system and vaccinations. The ability to draw blood, look at immune system responses, identify high risk patients and vaccinate them will support targeted breast cancer therapies and help patients long term.
The Office of Disease Prevention and Health Promotion’s Healthy People 2020 site provides the U.S federal cancer research goals and objectives.
If you want to learn more about the issue of cancer health disparities from the National Institute of Health (NIH), please visit; Why Research on Cancer Health Disparities Is Critical to Progress Against the Disease.