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Review
. 2018 Feb;188(2):304-316.
doi: 10.1016/j.ajpath.2017.06.019. Epub 2017 Nov 11.

Analysis of Tumor Biology to Advance Cancer Health Disparity Research

Cheryl J Smith  1 , Tsion Z Minas  1 , Stefan Ambs  2
Affiliations
Review

Analysis of Tumor Biology to Advance Cancer Health Disparity Research

Cheryl J Smith et al. Am J Pathol. 2018 Feb.

Abstract

Cancer mortality rates in the United States continue to decline. Reductions in tobacco use, uptake of preventive measures, adoption of early detection methods, and better treatments have resulted in improved cancer outcomes for men and women. Despite this progress, some population groups continue to experience an excessive cancer burden when compared with other population groups. One of the most prominent cancer health disparities exists in prostate cancer. Prostate cancer mortality rates are highest among men of African ancestry when compared with other men, both in the United States and globally. This disparity and other cancer health disparities are largely explained by differences in access to health care, diet, lifestyle, cultural barriers, and disparate exposures to carcinogens and pathogens. Dietary and lifestyle factors, pathogens, and ancestry-related factors can modify tumor biology and induce a more aggressive disease. There are numerous examples of how environmental exposures, like tobacco, chronic stress, or dietary factors, induce an adverse tumor biology, leading to a more aggressive disease and decreased patient survival. Because of population differences in the exposure to these risk factors, they can be the cause of cancer disparities. In this review, we will summarize recent advances in our understanding of prostate and breast cancer disparities in the United States and discuss how the analysis of tumor biology can advance health disparity research.

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Figures

Figure 1
Figure 1
Analysis of tumor biology to advance cancer health disparity research. A precision medicine approach is shown for cancer health disparity research that uses an integrated analysis of tumor tissues and other biospecimens, clinical data, survey and exposure data (eg, diet and lifestyle, environmental exposures, family and sexual history, occupation, social isolation, and discrimination), and patient characteristics (eg, socioeconomic status, body mass index, comorbidities, and genetic ancestry).
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