Department of Internal Medicine, Division of Hematology and Medical Oncology, West Virginia University Cancer Institute, West Virginia University, Wheeling, WV, USA.
Department of Internal Medicine, Division of Hematology, Clara D Bloomfield Center for Leukemia Outcomes Research, The Ohio State University Comprehensive Cancer Center, Columbus, OH, USA.
Lancet Haematol. 2021 Dec;8(12):e947-e954. doi: 10.1016/S2352-3026(21)00303-3.
Most studies of racial and ethnic survival disparities in patients with cancer diagnosed and treated in the USA have pertained to patients with solid tumours. However, increasing research on health inequities shows that these differences also extend to patients with haematological malignancies. In particular, Black and Hispanic patients with cancer have had markedly worse survival outcomes for several decades, although the need to critically evaluate and address these disparities has, for several compelling reasons, gained a greater sense of urgency. To effectively implement strategies to counteract barriers that underlie survival disparities and systemic racism, understanding the current state of survival outcomes for patients with haematological cancers who are racially or ethnically minoritised is important. In this Viewpoint, we review the specifics of outcome differences across haematological malignancies and investigate the contributions of race-associated differences in administration of treatment and genetic differences in underlying disease biology. We also provide our perspective on key actions that we feel are crucial for the haematology community to pursue to abrogate systemic racism and ensure fair and equitable care for all.
大多数关于在美国诊断和治疗的癌症患者的种族和民族生存差异的研究都涉及实体肿瘤患者。然而，越来越多的关于健康不平等的研究表明，这些差异也延伸到了血液恶性肿瘤患者身上。特别是，几十年来，患有癌症的黑人和西班牙裔患者的生存结果明显更差，尽管出于几个令人信服的原因，迫切需要认真评估和解决这些差异。为了有效实施克服生存差异和系统性种族主义基础障碍的策略，了解在种族或民族上处于少数地位的血液癌患者的生存结果现状很重要。在本观点中，我们回顾了血液恶性肿瘤中结局差异的具体情况，并研究了治疗管理中与种族相关的差异以及潜在疾病生物学中遗传差异的贡献。我们还就我们认为血液学领域必须采取的关键行动提供了看法，以消除系统性种族主义并确保为所有人提供公平和公平的护理。
