The Community Oncology Alliance (COA) recognizes there are profound and widespread disparities in cancer burden and cancer care among various groups and seeks to diminish these disparities whenever possible. It is estimated that 34% of cancer deaths among US adults aged 25 to 74 could be prevented if socioeconomic disparities were eliminated.1 Such disparities are pervasive, sometimes obvious, but often unconscious in nature.
There are disparities in all aspects of cancer care: access to screening, access to care, and the ability to pay for care. Diverse racial/ethnic groups often do not have proper access to screening or to quality cancer care. Too often, such individuals arrive for care with cancer in a later stage, and thus a poorer prognosis. They struggle to pay for care and carry the burden of significant financial toxicity of their cancer care. Failure to include multiple ethnic groups in clinical trials results in more disparities, making new treatments and precision medicine less applicable and less available to patients beyond those of European descent.
Cancer disparities can be seen despite improving outcomes overall, but nonetheless are missing in some groups. Population groups who may experience cancer disparities include groups defined by race/ethnicity, disability, gender identity, geographic location, income, education, age, sexual orientation, national origin, and/or other characteristics.2
COA believes health care disparities must be addressed to ensure that cancer care is more equitable, available, and effective for all Americans. We call on the relevant federal
agencies, other cancer-related organizations, and Congress to join in efforts to eliminate disparities. Health care inequality will likely worsen with advances in therapy and the use of precision oncology unless parallel work to address health care disparities occurs. Failure to address systemic bias in health care provision and genetic databases will make existing disparities worse.3 At the forefront of the COA mission is a recognition of health care disparity and the impact that it has to many Americans facing cancer. The hope is to include this important issue as part of all COA initiatives.
As an individual advocacy organization, we cannot begin to address every aspect of disparities. However, COA and its members strive to recognize disparities whenever possible and are committed to being leaders in collective efforts to end them.
1. Siegel RL, Jemal A, Wender RC, Gansler T, Ma J, Brawley OW. An assessment of progress in cancer control. CA Cancer J Clin. 2018;68(5):329-339. doi:10.3322/caac.21460
2. Cancer Disparities. National Cancer Institute at the National Institutes of Health.
Updated November 17, 2020. Accessed May 3, 20221. www.cancer.gov/about-cancer/understanding/disparities
3. Madhusoodnan J. Healthcare inequality could deepen with precision oncology.
Nature. 2020;585:S13-S15. doi:10.1038/d41586-020-02678-7