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Avoiding Pro Forma: A Health Equity–Conscious Approach to Cancer Control Research

Published:December 22, 2021DOI:https://doi.org/10.1016/j.amepre.2021.09.021
      Over the last 30 years, cancer mortality rates have fallen significantly,
      • Siegel RL
      • Miller KD
      • Fuchs HE
      • Jemal A.
      Cancer statistics, 2021.
      but these benefits have not been experienced consistently across all populations or geographical areas. The avoidable differences or disparities in cancer outcomes are largely attributed to the historical and contemporary structures, processes, practices, and policies that create or reinforce the inequitable allocation and accessibility of resources, services, and opportunities, thereby hindering the attainment of the highest level of health for all—health equity.
      • Bailey ZD
      • Krieger N
      • Agénor M
      • Graves J
      • Linos N
      • Bassett MT.
      Structural racism and health inequities in the USA: evidence and interventions.
      These inequities permeate the structural conditions in which people live, learn, work, play, and age, known as the social determinants of health (SDOH).
      National Academies of
      Hence, the authors propose a move away from merely a disparities-centered research to an equity agenda within the mission of the National Cancer Institute (NCI) to account for the social context(s) and need(s) of communities for cancer prevention and control research. This paper argues for a more comprehensive and reflective cancer control research approach, that is a health equity–conscious approach, where researchers avoid pro forma and break from the traditional majority-centric health disparities research paradigm.
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      REFERENCES

        • Siegel RL
        • Miller KD
        • Fuchs HE
        • Jemal A.
        Cancer statistics, 2021.
        CA Cancer J Clin. 2021; 71: 7-33https://doi.org/10.3322/caac.21654
        • Bailey ZD
        • Krieger N
        • Agénor M
        • Graves J
        • Linos N
        • Bassett MT.
        Structural racism and health inequities in the USA: evidence and interventions.
        Lancet. 2017; 389: 1453-1463https://doi.org/10.1016/s0140-6736(17)30569-x
        • National Academies of
        Sciences Engineering Medicine.Communities in action: pathways to health equity. National Academies Press, Washington, DC2017
        • Zahnd WE
        • McLafferty SL.
        Contextual effects and cancer outcomes in the United States: a systematic review of characteristics in multilevel analyses.
        Ann Epidemiol. 2017; 27: 739-748.e3https://doi.org/10.1016/j.annepidem.2017.10.002
        • Carrot-Zhang J
        • Chambwe N
        • Damrauer JS
        • et al.
        Comprehensive analysis of genetic ancestry and its molecular correlates in cancer.
        Cancer Cell. 2020; 37: 639-654.e6https://doi.org/10.1016/j.ccell.2020.04.012
        • Mills MC
        • Rahal C.
        The GWAS Diversity Monitor tracks diversity by disease in real time.
        Nat Genet. 2020; 52: 242-243https://doi.org/10.1038/s41588-020-0580-y
        • Salman A
        • Nguyen C
        • Lee YH
        • Cooksey-James T.
        A review of barriers to minorities’ participation in cancer clinical trials: implications for future cancer research.
        J Immigr Minor Health. 2016; 18: 447-453https://doi.org/10.1007/s10903-015-0198-9
        • Pacheco CM
        • Daley SM
        • Brown T
        • Filippi M
        • Greiner KA
        • Daley CM.
        Moving forward: breaking the cycle of mistrust between American Indians and researchers.
        Am J Public Health. 2013; 103: 2152-2159https://doi.org/10.2105/ajph.2013.301480
        • Scharff DP
        • Mathews KJ
        • Jackson P
        • Hoffsuemmer J
        • Martin E
        • Edwards D.
        More than Tuskegee: understanding mistrust about research participation.
        J Health Care Poor Underserved. 2010; 21: 879-897https://doi.org/10.1353/hpu.0.0323
        • Blake KD
        • Moss JL
        • Gaysynsky A
        • Srinivasan S
        • Croyle RT.
        Making the case for investment in rural cancer control: an analysis of rural cancer incidence, mortality, and funding trends.
        Cancer Epidemiol Biomarkers Prev. 2017; 26: 992-997https://doi.org/10.1158/1055-9965.epi-17-0092
      1. Rural action plan. HHS. https://www.hhs.gov/sites/default/files/hhs-rural-action-plan.pdf. Published 2020. Accessed October 15, 2021.

        • James WL.
        All rural places are not created equal: revisiting the rural mortality penalty in the United States.
        Am J Public Health. 2014; 104: 2122-2129https://doi.org/10.2105/ajph.2014.301989
        • Hoppe TA
        • Litovitz A
        • Willis KA
        • et al.
        Topic choice contributes to the lower rate of NIH awards to African-American/black scientists.
        Sci Adv. 2019; 5: eaaw7238https://doi.org/10.1126/sciadv.aaw7238
        • Mlinarić A
        • Horvat M
        • Šupak Smolčić V
        Dealing with the positive publication bias: why you should really publish your negative results.
        Biochem Med. 2017; 27030201https://doi.org/10.11613/bm.2017.030201
        • McElfish PA
        • Purvis RS
        • Esquivel MK
        • et al.
        Diabetes disparities and promising interventions to address diabetes in Native Hawaiian and Pacific Islander populations.
        Curr Diab Rep. 2019; 19: 19https://doi.org/10.1007/s11892-019-1138-1
        • Srinivasan S
        • Moser RP
        • Willis G
        • et al.
        Small is essential: importance of subpopulation research in cancer control.
        Am J Public Health. 2015; 105: S371-S373https://doi.org/10.2105/ajph.2014. 302267
      2. National Academies of Sciences Engineering Medicine. Improving health research on small populations: proceedings of a workshop. The National Academies Press, Washington, DC2018
        • Hall K
        • Vogel AL
        • Croyle RT
        Strategies for Team Science Success.
        Springer International Publishing, Switzerland2019
        • Martin DN
        • Lam TK
        • Brignole K
        • et al.
        Recommendations for cancer epidemiologic research in understudied populations and implications for future needs.
        Cancer Epidemiol Biomarkers Prev. 2016; 25: 573-580https://doi.org/10.1158/1055-9965.epi-15-1297
        • Schmitz KH
        • Gehlert S
        • Patterson RE
        • et al.
        TREC to WHERE? Transdisciplinary research on energetics and cancer.
        Clin Cancer Res. 2016; 22: 1565-1571https://doi.org/10.1158/1078-0432.ccr-14-1214