Identifying the Causes of Cancer Health Disparities: Biologic and Non Biologic Determinants.

The causes of cancer health disparities amongst Pacific Islanders and other racial groups are complex and multifactorial. Both biologic and non biologic determinants have been identified as causal factors. Racial/ethnic classification can be used as a surrogate for non biologic determinants such as place of geographic origin, socioeconomic status, cultural practices, and diet. Given that non biologic and biologic determinants are not mutually exclusive, using racial/ethnic classification may be hypothesis generating and assist in the identification of biologic determinants such as infections, toxins, and/or environmental exposures that lead to carcinogenesis. This commentary provides several examples of cancer specific biologic determinants that may lead to cancer health disparities. It also discusses specific non biologic determinants of cancer health disparities that must be overcome in order to increase participation of underserved populations in clinical trial research. Taken together, these examples demonstrate the need to further our understanding of the determinants of cancer health disparities that can lead to the enactment of preventive measures and/or targeted therapies.