Department of Internal Medicine, New York Medical College at Saint Michael's Medical Center, Newark, NJ, USA.
Department of Cardiovascular Medicine, Mayo Clinic, Phoenix, AZ, USA.
Curr Oncol Rep. 2024 Oct;26(10):1205-1212. doi: 10.1007/s11912-024-01578-7. Epub 2024 Jul 13.
Analyze current evidence on racial/ethnic disparities in cardiovascular outcomes among cancer survivors, identifying factors and proposing measures to address health inequities.
Existing literature indicates that the Black population experiences worse cardiovascular outcomes following the diagnosis of both initial primary cancer and second primary cancer, with a notably higher prevalence of cardio-toxic events, particularly among breast cancer survivors. Contributing socioeconomic factors to these disparities include unfavorable social determinants of health, inadequate insurance coverage, and structural racism within the healthcare system. Additionally, proinflammatory epigenetic modification is hypothesized to be a contributing genetic variation factor. Addressing these disparities requires a multiperspective approach, encompassing efforts to address racial disparities and social determinants of health within the healthcare system, refine healthcare policies and access, and integrate historically stigmatized racial groups into clinical research. Racial and ethnic disparities persist in cardiovascular outcomes among cancer survivors, driven by multifactorial causes, predominantly associated with social determinants of health. Addressing these healthcare inequities is imperative, and timely efforts must be implemented to narrow the existing gap effectively.
分析癌症幸存者心血管结局的种族/民族差异的现有证据，确定相关因素并提出解决健康不平等的措施。
现有文献表明，黑人在诊断出原发性癌症和第二原发性癌症后，心血管结局更差，心脏毒性事件的发生率明显更高，尤其是乳腺癌幸存者。导致这些差异的社会经济因素包括不利的健康决定因素、保险覆盖不足以及医疗保健系统中的结构性种族主义。此外，促炎的表观遗传修饰被假设为一个促成的遗传变异因素。解决这些差异需要采取多方面的方法，包括努力解决医疗保健系统中的种族差异和健康的社会决定因素、完善医疗保健政策和可及性，并将历史上受污名化的种族群体纳入临床研究。癌症幸存者心血管结局的种族和民族差异仍然存在，其原因是多方面的，主要与健康的社会决定因素有关。解决这些医疗保健不平等问题至关重要，必须及时采取措施有效地缩小现有差距。
