ONCOLOGY.
No. 4
The Raghavan Article Reviewed
Understanding Racial Disparities in Cancer Care
By
JEAN G. FORD, MD
Associate Professor
Department of Epidemiology
Johns Hopkins Bloomberg School of Public Health
Baltimore, Maryland
|
April 1, 2007
Groups defined by self-identified race or ethnicity (SIRE) show substantial within-group variation in genetic admixture. Similarly, between-group differences have been reported in the frequency of functional polymorphisms known to influence cancer initiation and progression. However, the potential contribution of between-group differences in allele frequencies to differences in cancer incidence is incompletely understood.
Studies of the complex and critical contribution of epigenetic changes are in their infancy. As new tools become available, it will be increasingly possible (and necessary) to design studies that integrate data on biologic and environmental factors, including social exposures. As suggested by Raghavan, such transdisciplinary approaches are essential to understanding the nature and magnitude of the effects of biologic differences on cancer incidence and mortality, and facilitating multilevel analyses to separate individual-level risk factors from the effects of contextual factors, as determinants of racial/ethnic disparities.[6]
—Jean G. Ford, MD
1. LaVeist TA: Disentangling race and socioeconomic status: A key to understanding health inequalities. J Urban Health 82(2 suppl 3):26-34, 2005.
2. Raghavan D: Disparities in cancer care: Challenges and solutions. Oncology (Williston Park) 21:493-506 (incl discussion), 2007.
3. Ford JG, Howerton MW, Bolen S, et al: Evidence Report on Knowledge and Access to Information on Recruitment of Underrepresented Populations to Cancer Clinical Trials. Evidence Report/ Technology Assessment No 122. Prepared by the Johns Hopkins University Evidence-based Practice Center; Baltimore, Md; 2005.
4. Morello-Frosch R, Jesdale BM: Separate and unequal: Residential segregation and estimated cancer risks associated with ambient air toxics in U.S. metropolitan areas. Environ Health Perspect 114:386-393, 2006.
5. Briggs NC, Levine RS, Hall HI, et al: Occupational risk factors for selected cancers among African American and White men in the United States. Am J Public Health 93:1748-1752, 2003.
6. Gibbons MC, Brock M, Alberg AJ, et al: The sociobiologic integrative model (SBIM): Enhancing the integration of sociobehavioral, environmental, and biomolecular knowledge in urban health and disparities research. J Urban Health 84:198-211, 2007.
