In recent decades, the cancer research community has made great strides by bringing new, targeted, safer, and longer-lasting treatments to patients dealing with a variety of cancers. While this achievement is truly remarkable and laudable, a glaring fact is that these groundbreaking advances have not translated into progress for everyone.
The underserved and underrepresented segments of our society have not benefited much from the advancements made as a result of cancer research, thereby disproportionately bearing a higher burden of the disease. A host of issues, including lack of awareness, access to health care, community support, and socioeconomic status have stacked the deck against achieving equity in cancer care.
The American Association for Cancer Research (AACR) has long recognized this fundamental problem and launched the first conference on “The Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved” in 2007. The conference aims to advance the understanding of, and ultimately help eliminate, the disparities that represent a major public health problem in our country and around the world.
The 12th AACR Conference on The Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved will be held Sept. 20-23 at the Hilton San Francisco Union Square. Laura Fejerman, PhD, conference chair and associate professor in the department of medicine at University of California, San Francisco (UCSF), shared her thoughts on the conference, the progress that has been made, and the challenges that lie ahead in leveling the playing field for everyone affected by cancer.
What is the significance of the conference?
The Cancer Health Disparities series started as a way to bring together all the scientists working in the field at a time when it wasn’t a well-known and accepted topic, at a time when there were very few scientists studying disparities among minority communities, and at a time when this area of research was not highlighted in any other conferences. Now, the cancer research community as a whole is paying more attention to this important topic.
In addition to addressing the science of cancer health disparities, the conference provides a platform for minority investigators in cancer research. It provides opportunities to highlight the research of young minority investigators, and to allow these individuals to explore the field and make connections and collaborations as they try to secure funding for their research and make progress in their career.
This is the 12th conference on cancer health disparities. How far have we come in these 12 years in addressing this important issue?
I have a very positive view – I think we have come very far in these 12 years. The growth of this meeting reflects more availability of funds from the National Institutes of Health and other sources to prioritize research on cancer health disparities, leading to a lot more research in this area of inquiry. Recently, comprehensive cancer centers have been urged to address cancer health disparities, particularly to look into their catchment areas and aim to serve all populations equally. There’s a lot more to be done, but there definitely has been progress and we are heading in the right direction.
What are some of the key topics to be discussed at the conference?
One of the plenary sessions is focused on using science to inform tobacco policy. This important session discusses what scientists do and how that informs policymakers to transform the society. A talk by Dr. Robert A. Hiatt from UCSF, for instance, will discuss the policy for a ban on the sale of menthol and flavored tobacco products in San Francisco.
I’m very excited about the session on cancer health disparities in the LGBTQ community. The chair of the session, Dr. Madina Agénor, from New York, will talk about the intersection between gender identity and race/ethnicity in the context of getting vaccination against human papillomavirus. There is great context for this topic given the large and strong LGBTQ community we have in San Francisco. There are also concurrent sessions on border health disparities and cancer prevention initiatives in low- and middle-income countries. The latter session reflects on our international collaborations and features our members from countries that experience significant cancer health disparities.
There are sessions on disparities in response to immunotherapies, differences in the immune microenvironment, and disparities in treatment outcomes and adverse effects in certain patient populations. Another important topic to be addressed at the meeting is cancer health disparities in children, and in adolescents and young adults. There are many other hot topics, including disparities in basic cancer biology, genomics, and big data, that attendees can explore at the meeting.
What are some of the areas where we have made progress? What are the areas where progress is lacking?
There are a lot of new initiatives in cancer prevention, and screening and early detection; however, awareness and access are huge barriers. A lot of research is addressing these barriers in addition to efforts around outreach and access to quality treatment. We will be learning more about advances in these areas during the conference.
A huge challenge is availability of data on minority populations. As of today, we don’t have as much data available for ethnic minorities as we do for other populations. This significantly limits what we can learn about their disease and circumstances. I can give my personal research experience as an example. I am part of a large collaborative effort that put together the first genome-wide association study of breast cancer in Latino patients. But we could still only put together about a tenth of the number of samples of what studies on European populations could put together. This translates into slower progress in learning and developing, for example, a risk prediction model for that underserved population. It takes more time and money to catch up.
My personal opinion is that we have some systemic problems. I think the way the health care system works in the United States exacerbates disparities. We also have larger, societal issues, such as lack of access to quality education for children from underserved populations, large income gaps, and large groups of people living in poor neighborhoods, which ultimately translate into disparities in health. It is harder to make a huge difference in these areas that we all want to see.
What is in store for the future?
Hopefully we will have more data on underserved populations in the future and we will know more about the nature and causes of their disease. I’m optimistic. I look forward to new approaches in studying disparities. For example, these past 15 years we went from looking at one candidate gene to discovering them by the bunch and sequencing them. These technologies have been used to better understand the biology of tumor cells and the tumor microenvironment. I think some of these approaches will ultimately help in reducing disparities. However, the key to making significant progress will lie in providing more access to information and health care to the underserved and underrepresented populations backed by policy changes and implementation. This will complement and support the enormous progress being made by cancer researchers at their end.
In short, we will know a lot more about cancer health disparities in 10 years, and I hope that the knowledge gained will translate into real health equity through dialogue and by bringing all stakeholders to the table.
Editor’s note: In this video, Fejerman and conference cochairs Phyllis Pettit Nassi and Mariana C. Stern share their thoughts about the meeting:
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