Realizing the Bold Vision of Cancer Health Equity

• Exploring the Impact of Structural Racism on Cancer Disparities. Conference Cochair Melissa B. Davis, PhD, the leader of team SAMBAI (Societal, Ancestry, Molecular, and Biological Analyses of Inequalities)—a research project funded by a Cancer Grand Challenges grant from Cancer Research UK and the NCI that is focused on decoding the factors that cause and influence disparate cancer outcomes in underserved populations of African descent—opened the conference with a keynote address that explored how structural racism impacts health inequities. Dr. Davis noted that increasing our understanding of how structural racism impacts biology and diversifying patient cohorts are critical to delivering on the promise of precision medicine for all populations.

After the keynote, Chanita Hughes-Halbert, PhD, and Lauren E. McCullough, PhD, MSPH, moderated a plenary session on “Unraveling the Complex Web from Society’s Structures to Biological Pathways,” which explored in more depth the ideas presented by Dr. Davis.

• AACR Distinguished Lectureship on the Science of Cancer Health Disparities. Since 2010, this award has recognized an investigator whose novel and significant work has had or may have a far-reaching impact on the etiology, detection, diagnosis, treatment, or prevention of cancer health disparities. The 2024 recipient, Scarlett Lin Gomez, MPH, PhD, was honored for her cutting-edge research dedicated to ascertaining the impact of various social determinants of health—including discrimination, immigration-related stress, and contemporary redlining and racial bias in mortgage lending—on cancer disparities. Dr. Gomez delivered her lecture during the opening session of the conference.
• Impact of the Affordable Care Act (ACA) on Cancer Disparities. To mark the 10th anniversary of the launch of the ACA Health Insurance Marketplace—which helped reduce the percentage of Americans without health insurance from 14.4% to 7.7%—third-year medical student Sriya Kudaravalli and her colleagues presented a proffered paper that investigated whether this coverage expansion led to better cancer care for people across socioeconomic dimensions. Over the course of the study period, they found the receipt of guideline-concordant care increased after the implementation of the ACA on average per year for non-white patients (7.8%), those in rural areas (7.7%), and those in disadvantaged neighborhoods (3.5%).

• Impact of the Affordable Care Act (ACA) on Cancer Disparities. To mark the 10th anniversary of the launch of the ACA Health Insurance Marketplace—which helped reduce the percentage of Americans without health insurance from 14.4% to 7.7%—third-year medical student Sriya Kudaravalli and her colleagues presented a proffered paper that investigated whether this coverage expansion led to better cancer care for people across socioeconomic dimensions. Over the course of the study period, they found the receipt of guideline-concordant care increased after the implementation of the ACA on average per year for non-white patients (7.8%), those in rural areas (7.7%), and those in disadvantaged neighborhoods (3.5%).

Read a summary of Sriya Kudaravalli’s presentation and other studies of the ACA’s impact on cancer care on the AACR Blog


• Sexual Symptoms and Treatment Adherence After Breast Cancer. The poster sessions at the conference showcased a wide range of the latest research on cancer health disparities, including a study from Janeane N. Anderson, PhD, MPH, that focused on patients diagnosed with early-stage, hormone receptor-positive breast cancer that are prescribed a post-surgical regimen of adjuvant endocrine therapy (AET) to prevent recurrence by blocking estrogen effects. Side effects cause more than a third of these patients to discontinue AET; Dr. Anderson showed that Black and white patients experience these side effects in different ways, and that open communication with patients about their sexual health needs can help them adhere to treatment and improve their outcomes.

Read a summary of Dr. Anderson’s study on the AACR Blog

• AACR Annual Meeting 2024. Under the leadership of program chairs Keith T. Flaherty, MD, FAACR, and Christina Curtis, PhD, the AACR Annual Meeting featured a robust Cancer Disparities track. The 18 sessions in this track highlighted the latest science focused on cancer health disparities and the latest strategies for addressing inequities in resources for cancer diagnosis and care:

• Molecular Profiling in Breast Cancer and Racial/Ethnic Minorities: Remembering Edith P. Mitchell. AACR Fellow John D. Carpten, PhD, FAACR, chaired this Advances in the Science of Cancer Disparities Session, which was dedicated to the memory of Edith P. Mitchell, MD, a pioneering oncologist who died in January after a long and illustrious career dedicated to improving outcomes for cancer patients, particularly those from underrepresented populations. The session addressed genetic and genomic features of breast cancers in diverse cohorts and disparities in breast cancer biomarker testing that can impact treatment decisions.

• Digital Pathology to Support Expanded Screening Efforts. In a plenary session moderated by Vivek Subbiah, MD, on “Artificial Intelligence at the Interface,” Anant Madabhushi, PhD, discussed the emergence of digital pathology, which uses AI to assess tissue histology slides and predict cancer risk for patients. The technology could mitigate the lack of trained pathologists in low- and middle-income countries (LMICs), enhancing screening, improving outcomes, and reducing cancer disparities in those regions.

Learn more about AACR Annual Meeting presentations on digital pathology and other applications of artificial intelligence on the AACR Blog

• Applying Technologies to Build Capacity in Low- and Middle-income Countries. Kojo S.J. Elenitoba-Johnson, MD, moderated this methods workshop that discussed novel uses of technology to expand cancer care in under-resourced settings.

DIVERSITY, EQUITY, INCLUSION, AND BELONGING

Through education, training, and research funding—and with leadership support from its Minorities in Cancer Research Council—the AACR works to ensure that the cancer health care workforce reflects the community it serves. In addition, AACR programs and initiatives examine the structural and systemic biases in the cancer research enterprise and work to eliminate them.

• Funding Meritorious Underrepresented Investigators. The AACR Grants Program funds meritorious scientists from diverse backgrounds that are underrepresented in the cancer research community—including women, individuals working in low- and middle-income countries, and members of racial or ethnic minority groups. In 2024, a total of 20 grants totaling more than $2.9 million were awarded to support diversity, equity, and inclusion, launching the careers of promising researchers that will drive progress against cancer for all patients.
• Robert A. Winn Diversity in Clinical Trials: Design and Implementation of Clinical Trials Workshop in Partnership with the AACR. Established in 2021, the Robert A. Winn Diversity in Clinical Trials Award Program is implemented by the AACR and Virginia Commonwealth University and funded by the Bristol Myers Squibb Foundation to train 250 community-oriented clinical trial investigators by 2025. As part of the program, the AACR organizes an annual workshop on excellence in clinical trial implementation.

  Held in November and directed by Roy S. Herbst, MD, PhD, Priscilla Pemu, MD, Yu Shyr, PhD, FAACR, and program namesake Robert A. Winn, MD, FAACR, the 2024 edition of the AACR workshop educated the participants about clinical trial design and research practice by presenting the ongoing challenges in clinical research; highlighting the benefits of focusing on clinical research, specifically in underrepresented populations; and investigating the disconnect between communities and clinical trialists.

• Advancing the Careers of Minority Faculty. With the generous support of the NCI Center to Reduce Cancer Health Disparities, the AACR has offered grants to enable full-time minority faculty members and faculty members of Minority-serving Institutions to participate in the AACR Annual Meeting. In 2024, a total of 64 minority investigators working at the level of assistant professor or above received either an AACR Minority Scholar Award or a Minority-serving Institution Faculty Scholar in Cancer Research Award. The program provides the education and training needed to sustain a diverse pipeline of cancer scientists.

PATIENT ADVOCACY AND POLICY

The AACR catalyzes progress toward health equity by disseminating critical information to legislators, regulators, and the cancer community; by calling for action on policies that can improve public health; and by amplifying the voices of patient advocates in its programs.

• Patient Advocates at the Cancer Health Disparities Conference. During the AACR Conference on The Science of Cancer Health Disparities in September, patient advocates actively participated in the program as speakers, panelists, and attendees. Ricki Fairley, a survivor of stage 3a triple-negative breast cancer (TNBC) and the CEO of TOUCH, The Black Breast Cancer Alliance, delivered the advocate keynote address. Noting that 90% of the clinical trials that supported the approval of 82 novel therapeutics between 2015 and 2021 lacked adequate representation from Black patients, Ms. Fairley described several projects—including the When We Tri(al) campaign—that she has led to sign up nearly 20,000 Black women to participate in clinical trials.

  In addition, Kimlin Tan Ashing, PhD, moderated a special session titled “Advocacy at the Bench: Diverse Voices of Cancer Survivorship,” which featured five patient advocates offering practical insights on how the research community can optimize patient engagement in cancer research.

In addition, Kimlin Tan Ashing, PhD, moderated a special session titled “Advocacy at the Bench: Diverse Voices of Cancer Survivorship,” which featured five patient advocates offering practical insights on how the research community can optimize patient engagement in cancer research.

• The Black TNBC Sanctuary: A New Resource for Patients. Compared to white women, Black women are twice as likely to develop TNBC—the most aggressive and hardest to treat type of breast cancer—and are more likely to be diagnosed at a later stage. These disparities around risk and diagnosis of TNBC are a leading reason why Black women are about 40% more likely to die of breast cancer than white women.

  Ricki Fairley, who was diagnosed with stage 3a TNBC in 2011, experienced firsthand the lack of information and resources for Black women facing the challenges of TNBC. That experience led her to develop The Black TNBC Sanctuary, an online resource tailored specifically for Black TNBC patients. The Sanctuary website, which launched in November, was the result of a collaboration between Ms. Fairley's TOUCH, The Black Breast Cancer Alliance and the Triple Negative Breast Cancer Foundation, Nueva Vida, and the AACR. The AACR provided scientific expertise to the project, reviewing all medical content to ensure accuracy.

Visit the Black TNBC Sanctuary website



Learn more about the Black TNBC Sanctuary project on the AACR Blog