Improvements in preventive measures have had a significant impact in bending the cancer mortality curve; however, cancer is still the second leading cause of death in the United States.
Evidence suggests that Black patients are less likely than White patients to receive stage-appropriate treatment or guideline-concordant care across multiple types of invasive cancers.
- Compared to white patients, Black patients are less likely to receive a lung cancer screening after receiving a referral and are less likely to receive a provider recommendation for surgery for lung cancer. They are also more likely to refuse surgery after it is recommended.
- Black people also are less likely to be recommended for colorectal screening and are treated less frequently with chemotherapy and radiation for colorectal cancer compared to white patients.
- For breast and gynecological cancers, Black and Hispanic women are less likely than white women to receive certain evidence-based workup procedures or guideline-recommended treatments. Compared to white women with similar treatment plans, Black women more often have delays in breast cancer treatment initiation. Research has similarly found that compared to white patients, Black and Hispanic patients have increased delays in receipt of surgery for breast cancer. While less studied, work has found that Asian women have a higher rate of receiving no follow-up after abnormal breast cancer screening compared to white women.
Systemic transformation in equitable cancer care requires an acknowledgment of structural racism as a root cause of disparities. A shared vision for equitable, high-quality care integrates patient engagement practices and antiracism strategies with health information technologies to correct these structural inequities and address cancer risk factors related to biology, patient behavior and timely access to care across populations. Systemic transformation requires that individuals and institutions alike accept accountability for our role in the system and commit to driving change through personal actions.