bims-cahedi Biomed News
on Cancer health disparities
Issue of 2023‒04‒23
nine papers selected by
Keshav K. Singh
University of Alabama at Birmingham


  1. Cancer. 2023 Apr 20.
      Despite significant progress in the early detection, treatment, and survivorship of cancer in recent decades, cancer disparities continue to plague segments of the US population. Many of these cancer disparities, especially those among historically marginalized racial and ethnic groups and those with lower socioeconomic resources, are caused and perpetuated by social and structural barriers to health. These social and structural barriers, which operate beyond the framework of cancer control, also systematically increase vulnerability to and decrease adaptive capacity for the deleterious effects of anthropogenic climate change. The established and emerging overlap between climate vulnerability and cancer risk presents complex challenges to cancer control, specifically among populations who suffer compounding hazards and intersectional vulnerabilities. By embracing these intersections, we may be able to conceptualize promising new research frameworks and programmatic opportunities that decrease vulnerability to a wide range of climate and health threats to advance health equity.
    Keywords:  cancer; cancer disparities; climate change; environmental indicators; social determinants of health; social vulnerability
    DOI:  https://doi.org/10.1002/cncr.34817
  2. Prev Sci. 2023 Apr 21.
      This article is a commentary on the publication titled, Strategic Directions in Prevention Intervention Research to Advance Health Equity, by R. C. Boyd et al.
    Keywords:  Health Disparities
    DOI:  https://doi.org/10.1007/s11121-023-01535-z
  3. MMWR Morb Mortal Wkly Rep. 2023 Apr 21. 72(16): 421-425
      Non-Hispanic Asian (Asian) and non-Hispanic Native Hawaiian and Pacific Islander (NHPI) persons represent growing segments of the U.S. population (1). Epidemiologic cancer studies often aggregate Asian and NHPI persons (2,3); however, because Asian and NHPI persons are culturally, geographically, and linguistically diverse (2,4), subgroup analyses might provide insights into the distribution of health outcomes. To examine the frequency and percentage of new cancer cases among 25 Asian and NHPI subgroups, CDC analyzed the most current 2015-2019 U.S. Cancer Statistics data.* The distribution of new cancer cases among Asian and NHPI subgroups differed by sex, age, cancer type, and stage at diagnosis (for screening-detected cancers). The percentage of cases diagnosed among females ranged from 47.1% to 68.2% and among persons aged <40 years, ranged from 3.1% to 20.2%. Among the 25 subgroups, the most common cancer type varied. For example, although breast cancer was the most common in 18 subgroups, lung cancer was the most common cancer among Chamoru, Micronesian race not otherwise specified (NOS), and Vietnamese persons; colorectal cancer was the most common cancer among Cambodian, Hmong, Laotian, and Papua New Guinean persons. The frequency of late-stage cancer diagnoses among all subgroups ranged from 25.7% to 40.3% (breast), 38.1% to 61.1% (cervical), 52.4% to 64.7% (colorectal), and 70.0% to 78.5% (lung). Subgroup data illustrate health disparities among Asian and NHPI persons, which might be reduced through the design and implementation of culturally and linguistically responsive cancer prevention and control programs, including programs that address social determinants of health.
    DOI:  https://doi.org/10.15585/mmwr.mm7216a2
  4. Health Sci Rep. 2023 Apr;6(4): e1208
      Background and Aims: Yoga is well-thought-out as an all-inclusive approach globally and can be administered in clinical care as an integrative or alternate approach to regular treatment. Yoga exercise has been disclosed to influence remission from cancer cells over a long period of time and also reverses epigenetic alterations. Applications of Yoga in the management of oral oncology patients are scarce, hence the need for a scoping review of the literature. Hence, this study aimed to conduct a scoping review of the existing empirical evidence on the applications of yoga in oral oncology.Methods: The review methodology was informed by Joanna Brigg's Institute guidelines for systematic scoping reviews, and the review was reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews. Ten databases were searched. The records of all the literature retrieved from the search were imported into the Rayyan software for deduplication. After the full-text screening, only two were found eligible for inclusion in the scoping review. Data obtained in the included literature were extracted and synthesized.
    Results: This review found that Yoga was not significantly effective in the management of stress among oral cancer patients (p-values > 0.04). However, it was found that Yoga significantly reduced anxiety, saliva stickiness, and episodes of falling ill (p-values < 0.05) while it improved mental well-being, cognitive functioning, emotional functioning, and head and neck pain of those oral cancer patients that received it (p-values < 0.05).
    Conclusion: An integrative care approach that considers nonpharmaceutical techniques such as yoga could help to reduce care cost while improving care outcomes and quality of life of oral cancer patients. Hence, it is imperative to consider yoga along with its potential benefits, and we recommend gradual incorporation of yoga into oral cancer care.
    Keywords:  Yoga therapy; meditation; oral cancer; scoping review
    DOI:  https://doi.org/10.1002/hsr2.1208
  5. Cancer Epidemiol Biomarkers Prev. 2023 Apr 17. pii: EPI-23-0038. [Epub ahead of print]
      BACKGROUND: Mortality from cervical cancer (CC) has declined steadily in the US over the past several decades due to widespread screening for precancerous and early-stage cervical cancer (ECC), which are significantly easier to treat compared to late-stage cervical cancer (LCC). Unequal screening access continues to cause significant racial/ethnic disparities in CC diagnosis stage. This study examined the underlying role of neighborhood-level socioeconomic disadvantage as a potential mediator of the association between race/ethnicity and CC diagnosis stage.METHODS: We analyzed Texas Cancer Registry data for CC cases diagnosed among women aged 18 or older from 2010 to 2018. We performed causal mediation analyses of the association between race/ethnicity and CC stage at diagnosis mediated by neighborhood-level socioeconomic disadvantage.
    RESULTS: Of the 9192 women with CC, 4720 (51.3%) had LCC at diagnosis. Compared to non-Hispanic White (NHW) women (106.13, standard deviation (SD)=13.32), non-Hispanic Black (NHB) (111.46, SD=9.55) and Hispanic (112.32, SD=9.42) women had higher area deprivation index (ADI) and had greater odds of LCC diagnosis (Total effects: adjusted odds ratios (AOR) = 1.29 (95% CI 1.11-1.46) and AOR 1.14 (95% CI 1.03-1.25), respectively). Approximately 34.7% and 71.6% of the disparity in LCC diagnosis were attributable to higher neighborhood socioeconomic disadvantage among NHB and Hispanic women, respectively.
    CONCLUSIONS: LCC disparity varied by race/ethnicity and was partly attributable to neighborhood disadvantage. The disparity among Hispanic women due to neighborhood deprivation was twice as high among NHB women.
    IMPACT: Findings may be used to develop targeted race- and place-specific interventions to improve cancer care equity.
    DOI:  https://doi.org/10.1158/1055-9965.EPI-23-0038
  6. J Adolesc Young Adult Oncol. 2023 Apr 19.
      Purpose: This study aimed to identify cancer incidence trends in the United States and globally in adolescents and young adults (AYAs) 15-39 years of age, by sex, and to speculate on causes for trend changes. Methods: For the United States, SEER*Stat was used to obtain average annual percent change (AAPC) trends in cancer incidence during the period 2000-2019 among 395,163 AYAs. For global data, the source was the Institute of Health Metrics and Evaluation and its sociodemographic index (SDI) classification system. Results: In the United States, the invasive cancer incidence increased during the period 2000-2019 in both females (AAPC: 1.05, 95% CI: 0.90-1.20, p << 0.001) and males (AAPC: 0.56, 95% CI: 0.43-0.69, p << 0.001). A total of 25 and 20 types of cancers increased statistically significantly in female and male AYAs, respectively. Among potential causes for the increases, the obesity epidemic in the United States strongly correlates with the overall cancer increase in both its female (Pearson correlation coefficient R2 = 0.88, p = 0.0007) and male (R2 = 0.83, p = 0.003) AYAs, as does the most common malignancy in American AYAs, breast cancer (R2 = 0.83, p = 0.003). Worldwide, cancer incidence in the age group increased steadily during the period 2000-2019 among high-middle, middle, and low-middle SDI countries, but not in low SDI countries and with slowing of increase in high SDI countries. Conclusions: The increases and their age-dependent profiles implicate several causations that are preventable, including obesity, overdiagnosis, unnecessary diagnostic radiation, human papilloma virus infection, and cannabis avoidance. The United States is beginning to reverse the increasing incidence, and prevention efforts should be augmented accordingly.
    Keywords:  adolescent and young adult; biology; epidemiology; etiology; increasing cancer incidence
    DOI:  https://doi.org/10.1089/jayao.2022.0134
  7. J Natl Cancer Inst. 2023 Apr 19. pii: djad069. [Epub ahead of print]
      BACKGROUND: Starting in 2018, national death certificates included a new racial classification system that accounts for multiple-race decedents and separates Native Hawaiian and Pacific Islander (NHPI) individuals from Asian individuals. We estimated cancer death rates across updated racial/ethnic categories, sex, and age.METHODS: Age-standardized U.S. cancer mortality rates and rate ratios from 2018-2020 among ≥20-year-olds were estimated with national death certificate data by race/ethnicity, sex, age, and cancer site.
    RESULTS: In 2018, there were approximately 597,000 cancer deaths, 598,000 in 2019, and 601,000 in 2020. Among men, cancer death rates were highest in Black men (298.2/100,000; n = 105,632), followed by White (250.8; n = 736,319), American Indian/Alaska Native (AI/AN) (249.2; n = 3,376), NHPI (205.6; n = 1,080), Latino (177.2; n = 66,167), and Asian (147.9; n = 26,591) men. Among women, Black women had the highest cancer death rates (206.5/100,000; n = 104,437), followed by NHPI (192.1; n = 1,141), AI/AN (189.9; n = 3,239), White (183.0; n = 646,865), Latina (128.4; n = 61,579), and Asian women (111.4; n = 26,396). The highest death rates by age group occurred among NHPI individuals aged 20-49 years, and Black individuals aged 50-69 and ≥70 years. Asian individuals had the lowest cancer death rates across age groups. Compared to Asian individuals, total cancer death rates were 39% higher in NHPI men and 73% higher in NHPI women.
    CONCLUSIONS: There were striking racial/ethnic disparities in cancer death rates during 2018-2020. Separating NHPI and Asian individuals revealed large differences in cancer mortality between two groups that were previously combined in vital statistics data.
    Keywords:  Cancer; Epidemiology; Ethnic group; Native Hawaiian and Pacific Islander
    DOI:  https://doi.org/10.1093/jnci/djad069
  8. Front Genet. 2023 ;14 1141058
      Background: Non-Small Cell Lung Cancer (NSCLC), the leading cause of cancer-related death in the United States, is the most diagnosed form of lung cancer. While lung cancer incidence has steadily declined over the last decade, disparities in incidence and mortality rates persist among African American (AA), Caucasian American (CA), and Hispanic American (HA) populations. Researchers continue to explore how genetic ancestry may influence differential outcomes in lung cancer risk and development. The purpose of this evaluation is to highlight experimental research that investigates the differential impact of genetic mutations and ancestry on NSCLC incidence. Methods: This systematic review was conducted using PubMed and Google Scholar search engines. The following key search terms were used to select articles published between 2011 and 2022: "African/European/Latin American Ancestry NSCLC"; "Racial Disparities NSCLC"; "Genetic Mutations NSCLC"; "NSCLC Biomarkers"; "African Americans/Hispanic Americans/Caucasian Americans NSCLC incidence." Systematic reviews, meta-analyses, and studies outside of the US were excluded. A total of 195 articles were initially identified and after excluding 156 which did not meet eligibility criteria, 38 were included in this investigation. Results: Studies included in this analysis focused on racial/ethnic disparities in the following common genetic mutations observed in NSCLC: KRAS, EGFR, TP53, PIK3CA, ALK Translocations, ROS-1 Rearrangements, STK11, MET, and BRAF. Results across studies varied with respect to absolute differential expression. No significant differences in frequencies of specific genetic mutational profiles were noted between racial/ethnic groups. However, for HAs, lower mutational frequencies in KRAS and STK11 genes were observed. In genetic ancestry level analyses, multiple studies suggest that African ancestry is associated with a higher frequency of EGFR mutations. Conversely, Latin ancestry is associated with TP53 mutations. At the genomic level, several novel predisposing variants associated with African ancestry and increased risk of NSCLC were discovered. Family history among all racial/ethnic groups was also considered a risk factor for NSCLC. Conclusion: Results from racially and ethnically diverse studies can elucidate driving factors that may increase susceptibility and subsequent lung cancer risk across different racial/ethnic groups. Identification of biomarkers that can be used as diagnostic, prognostic, and therapeutic tools may help improve lung cancer survival among high-risk populations.
    Keywords:  biomarkers; genetic ancestry; genetics; lung cancer; non-small cell lung cancer; racial disparities; risk factors
    DOI:  https://doi.org/10.3389/fgene.2023.1141058
  9. Front Neurol. 2023 ;14 1139746
      Objective: The study aimed to analyze the research status, hotspots, and frontiers of global research on cancer and sleep through bibliometrics and provide references and guidance for future research.Methods: The literature regarding cancer and sleep from 2002 to 2022 was searched from the Web of Science Core Collection (WoSCC) database. CiteSpace 5.6.R3 was performed for visualization analysis.
    Results: A total of 1,172 publications were identified. The number of publications in the field has gradually increased over the past two decades. The United States had the most prominent contributions. Taipei Medical University and the University of California, San Francisco, and David Gozal were the most prolific institutions and author, respectively. The most published academic journal was Supportive Care in Cancer. The research hotspots can be summarized into the symptom cluster intervention for cancer survivors and the association between cancer and melatonin and/or obstructive sleep apnea (OSA). The complex interaction between cancer and sleep disruption and the influencing factors of sleep quality may be the emerging trends of research.
    Conclusion: This study systematically analyzed the hotspots and frontiers in the field of cancer and sleep and called for strengthening cooperation among countries, institutions, and authors. In addition, intervention measures for the cancer symptom cluster, the bioavailability of exogenous melatonin, the causal relationship between OSA and cancer, the mechanism of tumor-induced sleep disruption, the dose-response relationship between sleep duration and cancer risk, and the path relationship between sleep quality influencing factors may be the focus of future research.
    Keywords:  CiteSpace; bibliometrics; cancer; sleep; visualization analysis
    DOI:  https://doi.org/10.3389/fneur.2023.1139746