Chief Medical Officer Otis W. Brawley Responds to President's Panel on Cancer Report on Racial and Ethnic Disparities
April 28, 2011 The President's Panel on Cancer has released a report on health disparities that points to an urgent need to expand research and improve understanding of the factors that influence cancer risk and outcomes among diverse populations. The Panel's report, America’s Demographic and Cultural Transformation: Implications for Cancer, states that knowledge of cancer risk, incidence, progression, and outcomes is based largely on studies of non-Hispanic white populations. Therefore, the current understanding of risk factors, screening guidelines, and treatment may not be appropriate for individuals of non-European descent. The Panel also calls for higher standards of "cultural competence" among healthcare professionals to better address cultural and language barriers that can negatively impact the quality of patient care.
Below are comments from Otis W. Brawley, M.D., the American Cancer Society's chief medical officer.
"The Presidents Cancer Panel publication, 'America's Demographic and Cultural Transformation: Implications for Cancer,' is a well-developed synthesis of the issue of disparities in health. We thank the panel members and their staff and recognize the diligence that went into compiling and writing this landmark report.
"The publication rightly describes cancer as a problem that is worse in certain populations be they defined by race/ethnicity, socioeconomic status, or area of residence (rural vs urban). The expansion of the issue beyond Black/White race is especially important. Population biologists need to help medical science in meaningful categorization of the population as we assess cancer impact and the outcomes of cancer control programs.
"Overwhelmingly clear is the fact that in order to advance our control of this disease we must understand the role that culture, habits, and environment play in cancer causation and the cancer treatment experience. We must also understand that the role of genetics in cancer is significant but it is not the whole story, and we must not let that blind us from seeing other factors at work here. The report clearly points out that race is a social and not a biologic construct, a point few Americans understand.
"The publication notes that some trends are very favorable at this time. Cancer mortality rates are trending downward faster among African Americans than among whites, and if this current trend continues, the disparity may disappear in the next twenty years. At the same time it is clear that a significant portion of the American population, however one defines them, is currently not receiving adequate cancer prevention and adequate cancer treatment. Interventions to provide access to adequate care to those who do not get it is imperative as American lives are being lost as a result."