As oncology professionals, we strive to improve survival and quality of life in all patients. June has several events to remind us of the rights of people of all colors (Juneteenth [June 19]—the anniversary of when the end of slavery in Texas was finally enforced), age (June 15—World Elder Abuse Awareness Day ), and gender and sexual orientation (Pride month). However, it also has the solstice, when half of the world is enjoying their greatest amount of daylight while the other half has their longest period of darkness.
Currently, cancer rates in the US are highest for Whites, but mortality from cancer is highest among patients who are Black. Mortality rates for prostate cancer, colorectal cancer, and breast cancer are relatively worse among the Black community than any other ethnic or racial group. These are patients who present at practices all around America, and the battlegrounds for progress are in the communities. One obstacle is cultural, and there is a need to better relate to the values and challenges of this population. Another is financial—and the Supreme Court recently upheld aspects of the Affordable Care Act. However, without clinical trial evidence for new and emerging therapies in minority populations, it is unclear if we really are doing what is best for these underserved communities.
Health equality was a central issue at this year’s American Society of Clinical Oncology (ASCO) meeting. ASCO’s 2020–2021 president, Lori J. Pierce, MD, FASTRO, FASCO, addressed the meeting with an opening presentation on “Equity: Every Patient. Every Day. Everywhere.” On behalf of ASCO, she explicitly condemned racism and its profound impacts on public health, committing key resources and reviewing their initiatives to confront it. Racism can undermine all efforts against cancer. Dr Pierce asserted, “We must pour the same energy and focus into confronting racism as we pour into conquering cancer itself.”
In the past, clinical trials have failed to recruit a representative proportion of minority patients, including Black and Latino individuals. ASCO was instrumental in ensuring that the Clinical Treatment Act was passed into law in December, and Medicare now must cover the costs for Medicare patients to enroll in clinical trials. However, the active support of the oncology community is necessary to help achieve adequate minority representation in clinical trials. Together, we can each play a role in ensuring that optimal outcomes can be achieved in all patients throughout the country.