Cancer Disparities Research

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The Importance of Cancer Disparities Research

Although there has been substantial progress in cancer prevention, screening, diagnosis, and treatment over the past several decades, certain groups still have a higher incidence of some cancers, have higher cancer death rates, are more likely to be diagnosed with advanced cancer, are more likely to experience certain cancer-causing exposures, are less likely to have proven screening tests, and are less likely to be treated according to guidelines.

These cancer disparities are frequently seen in people with low-socioeconomic status, certain racial/ethnic populations, and those who live in geographically isolated areas, among others.

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NCI Cancer Disparities Research and the National Cancer Plan

NCI supports a broad variety of research to understand and address the unequal burden of cancer. This work aligns with the National Cancer Plan’s goal to eliminate inequities. Read about the plan and this goal.

There is evidence of progress against cancer disparities in recent years. But researchers and public health officials agree that progress has come too slowly, and the cost of disparities—in terms of premature deaths, lost productivity, and the impact on communities—remains substantial and must be addressed.

Studies suggest that the differences observed in cancer incidence and mortality between various population groups are the result of a complex interplay of social, environmental, and genetic factors.

For example, access to care is a critical contributor to cancer health inequity. It is influenced by a web of factors, such as insurance status and proximity to health care facilities.

Developing ways to improve access to quality cancer care continues to be one of the most daunting challenges facing the cancer research community.

Beyond access, a complex mix of factors may contribute to differences in disease outcomes among different groups—factors that may be environmental (e.g., exposure to secondhand smoke), behavioral (e.g., higher rates of alcohol use and physical inactivity), cultural (e.g., mistrust of the health care system and fatalistic attitudes about cancer), societal (e.g., systemic racism and social injustice), and biological (e.g., genetic factors that contribute to higher cancer incidence and death rates in certain populations).

As researchers fine tune their understanding of the underlying biology of cancer, they are learning more about how biological differences and the interplay of social determinants of health and biology may contribute to cancer disparities. This greater understanding has the potential to produce more tailored approaches to prevention, diagnosis, treatment, and survivorship.

As the issue of health equity has gained more attention in the cancer research and public health communities, it has produced more opportunities for research collaborations. One area of collaboration involves efforts to increase the diversity of participants in clinical trials, which can ensure that trial findings are applicable to a broader patient population.

The greater recognition of cancer health equity has also prompted researchers to test community-level interventions that address the unique needs of specific populations in which disparities are particularly problematic.

Selected NCI Activities in Cancer Disparities Research

NCI Equity and Inclusion Program

Learn how NCI will help end structural racism in biomedical research and why the program was launched.

NCI is addressing cancer disparities and promoting health equity on numerous fronts. For example, the institute conducts and funds basic research on the biology behind disparities and large comprehensive studies examining the factors that contribute to disparities; tests community-level interventions that aim to overcome barriers to cancer care; and maintains population-based registries that help to document the extent of the problem and highlight areas for further study.

NCI conducts basic research on the contribution of genetic and biological factors to health disparities in several cancers, including lung, prostate, and breast cancer. Researchers use translational and epidemiological research strategies to identify risk factors associated with disparities and pathways that influence tumor development and progression. Researchers are conducting studies on the molecular basis of disparities in cancer outcomes and how they are influenced by nonbiological factors, such as the built environment or the course of treatment.
The Surveillance, Epidemiology, and End Results (SEER) Program collects cancer incidence, survival, and mortality data—by age, sex, race/ethnicity, and geography— and reports estimates of these and other measures that define the burden of cancer in the United States. These data help track progress against cancer and reveal areas in need of improvement. For example, survival rates for women diagnosed with breast cancer have been steadily improving over the past several decades. However, these improvements have not been shared equally, with African American women more likely to die of their disease.
To learn more about the genetic factors that may underlie the observed differences in breast cancer among African American women, NCI is funding the Breast Cancer Genetic Study in African-Ancestry Populations. In this collaborative effort, researchers from the African American Breast Cancer Consortium, the African American Breast Cancer Epidemiology and Risk Consortium, and the NCI Cohort Consortium are sharing biospecimens, data, and resources from 18 previous studies to examine the genetic causes of breast cancer in African American women.

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NCI FY26 Annual Plan & Professional Judgment Budget Proposal

Each year, NCI prepares a plan for advancing cancer research and proposes the budget required to fund a broad research portfolio.

NCI, the National Institute on Minority Health and Health Disparities, and the Prostate Cancer Foundation are supporting a large study on prostate cancer in African American men, called RESPOND. The study is investigating environmental and genetic factors to better understand why African American men disproportionally experience aggressive disease compared with men of other racial and ethnic groups.

NCI created five Centers for Cancer Control Research in Persistent Poverty Areas that will advance key priorities of the Cancer Moonshot—to reduce inequities in the structural drivers of cancer and prevent more cancers before they start—by carrying out interventions that address structural and institutional factors (e.g., increasing income tax credits, reducing tobacco use, addressing challenges in the built environment, and improving food security). These programs seek to overcome institutional barriers to cancer screening and increase adoption of healthy behaviors.
NCI’s Partnerships to Advance Cancer Health Equity (PACHE) program fosters collaboration among institutions serving underserved health disparity populations and underrepresented students and NCI-Designated Cancer Centers. The program seeks to achieve a greater understanding of the underlying causes of cancer disparities and supports cancer and cancer disparities research across the cancer continuum. To advance these goals, PACHE facilitates community engagement by people from underserved populations and supports the training and education of individuals from populations that are underrepresented in cancer research.
Inspiring a Diverse Generation of Cancer Scientists

YES program encourages underrepresented youth to pursue cancer research careers.

The Continuing Umbrella of Research Experiences (CURE) program funds a broad range of research training opportunities for individuals from underrepresented populations across the academic continuum, starting with middle school students and continuing through early-stage investigators. The CURE program has increased the participation of underrepresented individuals in biomedical, behavioral and clinical research. CURE’s holistic approach is intended to help individuals envision and achieve independence in a career in cancer research.
NCI will fund a network of multidisciplinary, multi-institutional Specialized Programs of Research Excellence (SPOREs) in Cancer Health Disparity and Minority Health (CHD-MH) to improve prevention, early detection, diagnosis, and treatment of cancer in populations that are underserved or underrepresented. The program will support translational research that addresses the interplay of various social determinants of health with the biology of the disease.
The NCI Community Oncology Research Program (NCORP) supports community-based clinical trials and cancer care delivery research. These community-based studies are helping to increase participation by minorities and patients from underserved populations in clinical cancer research. In addition, because the centers involved are often part of communities that experience disparities, NCORP cancer care delivery studies are ideally suited to test interventions designed to reduce cancer disparities. Twelve Minority/Underserved Community Sites, whose patient populations include at least 30% racial/ethnic minorities or rural residents, are funded within NCORP.
The Connecting Underrepresented Populations to Clinical Trials (CUSP2CT) program will implement and evaluate multilevel and culturally tailored outreach and education interventions to increase accrual of underrepresented racial and ethnic minority populations to NCI-supported NCORP, National Clinical Trials Network (NCTN), and Experimental Therapeutics Clinical Trials Network trials.