Department of Surgery, Weill Cornell Medical College, New York, New York.
Department of Biochemistry, St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia.
Cancer Discov. 2022 Jun 2;12(6):1428-1434. doi: 10.1158/2159-8290.CD-22-0278.
In order to accurately detect and prevent racial disparities, self-reported race (SRR) and ethnicity remain valuable tools; however, inaccurate capture of patient identity and broad aggregation of minoritized race groups present challenges for data interpretation. Also, although SRR is a proxy for shared social/cultural experience, it is not an accurate representation of shared endogenous factors. Biological investigations into cancer disparities, particularly those involving genetic features, should be framed in the context of genetic background or ancestry, as these are heritable aspects of population health. In reality, both genetics and environment work in concert to influence cancer risk and clinical outcomes. The best opportunity to define actionable means for reducing health disparities is in rigorous and comprehensive generation of rich data sets that characterize environmental, biological, and genetic components of disparate disease burden. To translate this pivotal disparities research into clinical tools and improved policies, we describe a diversity, equity, inclusion, and accessibility (DEIA) framework, which will increase participation from diverse backgrounds, reexamine previous research with a rigorous evaluation of appropriate SRR groupings, and engage community leaders to ensure that future research addresses the needs of communities at increased risk. On this path forward, we may finally end cancer disparities.
为了准确地发现和预防种族差异，自我报告的种族（SRR）和族裔仍然是有价值的工具；然而，患者身份的不准确捕捉和少数族裔群体的广泛聚合给数据解释带来了挑战。此外，尽管 SRR 是共享社会/文化经验的代理，但它并不是共享内源性因素的准确表示。对癌症差异的生物学研究，特别是涉及遗传特征的研究，应该在遗传背景或祖源的背景下进行，因为这些是人口健康的可遗传方面。实际上，遗传和环境协同作用，影响癌症风险和临床结果。定义减少健康差异的可行方法的最佳机会是在严格和全面地生成丰富的数据集，这些数据集描述了不同疾病负担的环境、生物和遗传组成部分。为了将这一关键的差异研究转化为临床工具和改进政策，我们描述了一个多样性、公平、包容和可及性（DEIA）框架，该框架将增加来自不同背景的参与，用严格的方法重新评估适当的 SRR 分组，并让社区领袖参与，以确保未来的研究能够满足处于高风险社区的需求。在这条前进的道路上，我们最终可能会消除癌症差异。
