Enhancing the Trajectories of Cancer Health Disparities Research: Improving Clinical Applications of Diversity, Equity, Inclusion, and Accessibility.

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.