Why issues that impact minorites with cancer affect everyone.
Why do we need to understand the various aspects of cancer that affect minorities, and why are they important to all of us?
Few would disagree that we should address unique barriers to prevention and care when it comes to minorities. But what can the details of cancer risk and outcome actually teach us about the biology of cancer and how it can have an impact on everyone at risk for or with cancer? Well, the story continues to unfold.
It is a story of convergence of the social, economic, and biological sciences—a story that began with the observation that certain minorities have a higher mortality rate from several types of cancer. It is still debated whether there is something biologically different, but some of the newer gene profiling technologies are now confirming that this is the case. In fact, as you’ll read in “Race, ­Genetics & Cancer," there are numerous examples where we see how differences in our genetic backgrounds are manifesting themselves as differences in how cancers behave. Ethnicity represents genetic islands, and certain heritable diseases cluster in groups of individuals based on geographic and racial genetics.
But, of course, cancer is a result of nature (­genetics) and nurture (environment), so similarly, environmental and lifestyle factors shared by ­minority groups also can be very instructive about cancer biology. But there have been those who argue that the socioeconomic forces are much more responsible for the worse outcome seen in, for example, African-American women with breast cancer. In the military, where access to care is equal for all, the racial difference in outcome is not seen. So an understanding of the barriers to care that exist in certain subsets of our population can be applicable to everyone—many affluent people also experience similar barriers. If education and alternate models of health care delivery can work in disadvantaged individuals, maybe they can also be the solution to skyrocketing health care costs for all of us.
There will always be much to learn across the whole social-biological spectrum, and this area has become a high priority for research funding for understandable reasons. In this issue, we provide a cross-section of the cultural and scientific aspects of cancer in minority populations. I hope it allows you to appreciate the scope of the challenges, as well as universe of opportunities, that may arise from increased attention and research.