Despite the overall death rate from cancer in the U.S. falling by 33% between 1991 and 2020, many segments of the U.S. population experience a disproportionate cancer burden, according to the 2024 American Association for Cancer Research (AACR) Cancer Disparities Progress Report.
Communities in Chicago suffer from multiple health disparities, particularly for cancer. The South Side’s 800,000 residents, the majority of whom are Black and historically marginalized, face significantly higher rates of cancer.
“Cancer affects everyone, but advances in cancer prevention, early detection and treatment have not benefited everyone equally,” said Kunle Odunsi, MD, PhD, who served on the steering committee responsible for issuing the report. He is the director of the National Cancer Institute-designated University of Chicago Medicine Comprehensive Cancer Center (UCCCC), one of two such centers in Illinois.
Black communities suffer worse disparities
Cancer disparities are most stark in Black and Indigenous populations, which have the highest overall cancer death rates of all U.S. racial or ethnic groups. Black men are twice as likely to die from prostate cancer compared to white men. Even though the incidence of breast cancer is similar in Black and white women, Black women have a 40% higher likelihood of dying from it. Similarly, Black individuals are twice as likely to be diagnosed with and die from multiple myeloma.
Many of these inequities are rooted in a long history of racism, segregation and discrimination against marginalized population groups in the U.S. — especially in large cities like Chicago. For example, as noted in the report, an analysis of U.S. cancer deaths in the context of residential segregation caused by decades of redlining (discriminatory housing practices) found that between 2015 and 2019, residents of disadvantaged neighborhoods had a 22% higher mortality rate for all cancers combined compared to other residents.
On Chicago’s South Side, cancer is the second leading cause of death, with cancer death rates nearly twice the national average. Because of a lack of information, resources and access to care, South Side residents are frequently diagnosed with cancer later and have more issues getting treatment than those who live on the North Side.
Examining drivers of cancer disparities
Researchers are trying to better understand the major drivers of cancer disparities in order to identify ways to reduce them. The AACR report discussed biological, social and structural factors that adversely affect racial and ethnic minority groups and medically underserved populations.
Social drivers of health include factors such as place of residence, education, work opportunities, healthcare access, housing, transportation, exposure to racism, language and literacy, and access to healthy food, clean air, water and community resources.
Disparities between populations are also driven by biological factors related to ancestry and environmental exposures. These factors include not only inherited genetics and our bodies’ immune responses, but also contaminants in the air, water and food we consume and the settings in which we live and work.
Other major contributing factors discussed in the report are the lack of diversity in existing cancer genomics datasets; the underrepresentation of minority groups in clinical trials; and the lack of diversity in the cancer research and care workforce.
Pursuing equitable solutions
The AACR report emphasizes the complex and multifaceted nature of cancer disparities, which necessitates multidisciplinary and collaborative approaches to identify effective solutions.
“The UCCCC joins AACR in its commitment to prioritize cancer disparities research and ensure that no populations or communities are left behind,” Odunsi said.
Below are examples of how the UCCCC is putting research, education and community resources in place to address the critical challenges of cancer disparities and achieve health equity for all patients.
- UChicago Medicine is one of nine healthcare sites across the country enrolling hundreds of thousands of people from all racial, ethnic and socioeconomic backgrounds in the Connect for Cancer Prevention study. Over time, the data generated by study participants will allow researchers to gain insights into how cancer develops and what can be done to prevent it. Bringing the Connect study to Hyde Park and surrounding communities enables underrepresented groups to participate in — and benefit from — biomedical research.
- The UCCCC launched The Center to Eliminate Cancer Inequity (CinEQUITY) in February 2024 to serve as a hub to catalyze research aimed at eliminating cancer inequities.
- In September 2023, UChicago Medicine began construction on Chicago’s first freestanding center dedicated to cancer care and research. The new pavilion, slated to open in 2027, will provide patients and the South Side community access to the newest diagnostic innovations and leading-edge therapies.
- Odunsi was recently selected by the National Cancer Institute Center to Reduce Cancer Health Disparities to join the Cancer Equity Leaders group, a diverse team of premier cancer research leaders who will reimagine and transform the future of cancer health equity. This group will help guide NCI’s diversity training, biomedical workforce development, and community outreach and engagement initiatives.
- UChicago Medicine researchers received a grant from Stand Up To Cancer® (SU2C) in 2023 to determine if employing new methods of patient outreach — with or without engagement of a community ambassador — increase clinical trial participation among the underserved community on Chicago’s South Side.
- The UCCCC’s Office of Community Engagement and Cancer Health Equity forms strategic alliances with UChicago units and other healthcare organizations, as well as community, ethnic and faith-based groups, to create innovative programs that will increase access to care, reduce risk factors for cancer, reduce tobacco use, increase participation in cancer research and improve the quality of life for cancer patients and survivors.
- In the fall, the UCCCC will be holding its sixth Annual Cancer Disparities and Health Equity Symposium to foster science and discussion about advances in cancer health disparities research which are driving health equity locally and globally. The theme will center on environmental factors.
- At the UCCCC, many programs and pathways have been established to reduce cancer disparities by building a more diverse and inclusive cancer research and care workforce. These programs allows young people, the majority of whom are women or from backgrounds otherwise underrepresented in the sciences — to gain hands-on experience in the laboratories of established cancer researchers at the University of Chicago.
- The UCCCC created a unique internship with City Colleges of Chicago with the goals of providing introductory education about–and increasing the diversity of–the cancer clinical research workforce.
- Representatives from the UCCCC regularly visit lawmakers in Springfield, Illinois and Washington, D.C., to advocate for legislation that increases diversity in clinical trials and expands access to lifesaving cancer screening.
- The UCCCC established working groups to increase the recruitment and accrual of under-represented populations and individuals across the lifespan to cancer clinical trials.
