Cancer health disparities in racial/ethnic minorities in the United States

British Journal of Cancer, Год журнала: 2020, Номер 124(2), С. 315 - 332

Опубликована: Сен. 9, 2020

There are well-established disparities in cancer incidence and outcomes by race/ethnicity that result from the interplay between structural, socioeconomic, socio-environmental, behavioural biological factors. However, large research studies designed to investigate factors contributing aetiology progression have mainly focused on populations of European origin. The limitations clinicopathological genetic data, as well reduced availability biospecimens diverse populations, contribute knowledge gap potential widen health disparities. In this review, we summarise reported associated United States America (USA) for most common cancers (breast, prostate, lung colon), a subset other highlight complexity (gastric, liver, pancreas leukaemia). We focus commonly identified referred racial/ethnic minorities USA-African Americans/Blacks, American Indians Alaska Natives, Asians, Native Hawaiians/other Pacific Islanders Hispanics/Latinos. conclude even though substantial progress has been made understanding underlying disparities, marked inequities persist. Additional efforts needed include participants aetiology, biology treatment. Furthermore, eliminate it will be necessary facilitate access to, utilisation of, services all individuals, address structural inequities, including racism, disproportionally affect USA.

Язык: Английский

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Implicit Racial Bias and Unintentional Harm in Vascular Care

JAMA Surgery, Год журнала: 2025, Номер unknown

Опубликована: Фев. 26, 2025

Importance Implicit bias may influence physician treatment decisions and contribute to Black-White health disparities. There are limited data linking implicit with actual care delivery outcomes. Objective To determine whether racial is associated potentially harmful surgical selection for a cohort of patients peripheral artery disease–related claudication. Design, Setting, Participants This survey study, linked observational registry data, included eligible clinicians who participate in the Vascular Quality Initiative (VQI) among 960 centers. The VQI includes academic medical centers, teaching hospitals, community private practices. Eligible participants all vascular specialist members (N = 2512), whom 218 completed race association test (IAT) were linkable procedure-level data. study was conducted between October 2021 2022. Exposure Race IAT. Main Outcomes Measures Clinician-level results patient-level revascularization procedures performed adjusted odds performance any infrapopliteal procedure by patient measured via mixed-effects logistic regression models. as moderator claudication 1-year amputation assessed secondary outcome. Results Among specialists (mean [SD] age, 46 [9] years; 160 [73%] male), 157 (72%) had pro-White bias. Black treated significant increase receiving an compared total sample (adjusted ratio [AOR], 1.67; 95% CI, 1.12-2.48). When bias, increased amputation, regardless anatomic location treated, White (AOR, 2.34; 1.20-4.55). Conversely, no similar 0.93; 0.68-1.26) full 1.29; 0.33-4.99) patients. Conclusions Relevance These findings indicate that contributes outcome disparities US. suggest need system-level interventions transparently identify warn not aligned best practices reduce negative

Язык: Английский

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Disparities in Lung Cancer Treatment

Current Oncology Reports, Год журнала: 2022, Номер 24(2), С. 241 - 248

Опубликована: Янв. 26, 2022

Язык: Английский

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Effect of an Antiracism Intervention on Racial Disparities in Time to Lung Cancer Surgery

Journal of Clinical Oncology, Год журнала: 2022, Номер 40(16), С. 1755 - 1762

Опубликована: Фев. 14, 2022

Timely lung cancer surgery is a metric of high-quality care and improves survival for early-stage non-small-cell cancer. Historically, Black patients experience longer delays to than White have lower rates. Antiracism interventions shown benefits in reducing racial disparities treatment.

Язык: Английский

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A system‐based intervention to reduce Black‐White disparities in the treatment of early stage lung cancer: A pragmatic trial at five cancer centers

Cancer Medicine, Год журнала: 2019, Номер 8(3), С. 1095 - 1102

Опубликована: Фев. 4, 2019

Abstract Background Advances in early diagnosis and curative treatment have reduced high mortality rates associated with non‐small cell lung cancer. However, racial disparity survival persists partly because Black patients receive less than White patients. Methods We performed a 5‐year pragmatic, trial at five cancer centers using system‐based intervention. Patients diagnosed stage cancer, aged 18‐85 were eligible. Intervention components included: (1) real‐time warning system derived from electronic health records, (2) race‐specific feedback to clinical teams on completion rates, (3) nurse navigator. Consented compared retrospective concurrent controls. The primary outcome was receipt of treatment. Results There 2841 (16% Black) the group 360 (32% intervention group. For baseline, crude 78% for vs 69% ( P < 0.001); difference by race confirmed model adjusted age, site, stage, gender, comorbid illness, income‐odds ratio OR ) 0.66 (95% CI 0.51‐0.85, = 0.001). Within cohort, rate 96.5% 95% 0.56). Odds analysis 2.1 0.41‐10.4, 0.39) Between analyses parity Conclusion A tested gaps improved care all.

Язык: Английский

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Association of Medicaid expansion with racial disparities in cancer stage at presentation

Cancer, Год журнала: 2022, Номер 128(18), С. 3340 - 3351

Опубликована: Июль 12, 2022

This study evaluates the independent association of Medicaid expansion on stage presentation among patients Black and White race with colorectal (CRC), breast, or non-small cell lung cancer (NSCLC).A cohort CRC, breast cancer, NSCLC (2009-2017) in National Cancer Database was performed. Difference-in-differences (DID) analysis used to compare changes tumor at diagnosis between (MES) non-expansion states (non-MES) before after expansion. Predictive margins were calculated by race, year, insurance status account for effect heterogeneity. Stage migration determined measuring combined proportional increase I decrease IV disease diagnosis.Black gained less coverage than (6.0% vs 13.1%, p < 0.001) Among patients, there a shift towards increased early-stage (DID 3.5% 3.5%, respectively; decreased late-stage White: -3.5%; -2.5%; MES compared non-MES following Overall greater CRC (10.3% vs. 5.1%) (8.1% 6.7%) effects similar (White 4.8% 4.5%).An proportion residing presented earlier However, because is higher states, national racial disparities appear worse

Язык: Английский

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Systematic Review of Interventions Addressing Racial and Ethnic Disparities in Cancer Care and Health Outcomes

Journal of Clinical Oncology, Год журнала: 2024, Номер 42(13), С. 1563 - 1574

Опубликована: Фев. 21, 2024

Cancer health disparities result from complex interactions among socioeconomic, behavioral, and biological factors, disproportionately affecting marginalized racial ethnic groups. The objective of this review is to synthesize existing evidence on interventions addressing or in cancer-related care access clinical outcomes.

Язык: Английский

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Insurance Status as a Surrogate for Social Determinants of Health in Cancer Clinical Trials

JAMA Network Open, Год журнала: 2020, Номер 3(4), С. e203890 - e203890

Опубликована: Апрель 30, 2020

Joseph M. Unger, PhD; Charles D. Blanke, MD; Michael LeBlanc, William E. Barlow, Riha Vaidya, Scott Ramsey, Dawn L. Hershman, MD, MS

Язык: Английский

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Surgical Care for Racial and Ethnic Minorities and Interventions to Address Inequities

Annals of Surgery, Год журнала: 2023, Номер 278(2), С. 184 - 192

Опубликована: Март 30, 2023

Objective: Racial and ethnic inequities in surgical care the United States are well documented. Less is understood about evidence-based interventions that improve reduce or eliminate inequities. In this review, we discuss effective patient, surgeon, community, health system, policy, multi-level to identifying gaps intervention-based research. Background: Evidenced-based racial key achieving equity. Surgeons, trainees, researchers, policy makers should be aware of known disparities for prioritization resource allocation implementation. Future research needed assess effectiveness reduction patient-reported measures. Methods: We searched PubMed database English-language studies published from January 2012 through June 2022 care. A narrative review existing literature was performed have been associated with Results Conclusions: Achieving equity will require implementing evidenced-based quality minorities. Moving beyond description toward elimination prioritizing funding research, utilization implementation science community based-participatory methodology, principles learning systems.

Язык: Английский

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Treatment delays in patients with lung cancer: a retrospective study conducted at the National Cancer Institute of Mexico between 2004 and 2021

The Oncologist, Год журнала: 2025, Номер 30(4)

Опубликована: Апрель 1, 2025

Abstract Importance Lung cancer management involves navigating a complex pathway from symptom onset to treatment initiation, where delays can compromise outcomes. Objective To identify the length of intervals among Mexican lung patients, compare results other countries, and determinants delays. Design Retrospective study collecting patient records exploring interval in cancer. Setting The was conducted at Mexico’s National Cancer Institute. Participants 2645 patients with confirmed diagnosis between 2004 2021 were included analysis. Exposure Social health. Main Outcome Treatment (from treatment). Results Logistic regression models revealed significant associations various factors, including marital status, education, region, first presentation, type, political period. A comparison international guidelines highlighted substantial diagnosed Instituto Nacional de Cancerología externally. Conclusions Targeted interventions should consider characteristics enhance care efficiency. Concerns be raised about observed increase 2014 associated impact on survival rates. There is an urgency for timely interventions, continuous research, collaborative efforts optimize delivery outcomes Mexico.

Язык: Английский

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