Over the last 5 decades, following the signing of the National Cancer Act in 1971, scientists have made extraordinary progress in the treatment of cancer and hematological malignancies. These promising results have resulted in a steady decline in cancer death rates.
Extraordinary progress has also resulted in an increase in the number of survivors living with cancer. The foundation of these developments is a better understanding of cancer biology driving transformative science that is spurring advances in public health and breakthroughs across the continuum of cancer research and care.
However, as pointed out during the annual meeting of the American Association for Cancer Research (AACR) progress against cancer has not benefited everyone equally, and certain segments of the U.S. population shoulder a disproportionate burden of the disease. 
During the upcoming Virtual 13th AACR Conference on The Science of Cancer Health Disparities in Racial/Ethnic Minorites and the Medically Underserved, being held October 2, – 4, 2020, representatives from academia, industry, government, and the community is brought together to promote the exchange of novel ideas, discuss the latest findings in the field, and stimulate the development of new research on cancer health disparities.
The conference is expected to help advances the understanding of, and ultimately helps to eliminate, the disparities that represent a major public health problem in the United States and model potential solutions for implementation around the world.
A transdisciplinary field
The meeting program, build on the themes and data reported in the inaugural AACR Cancer Disparities Progress Report published on September 16, 2020, includes discussions on topics, including diversity and inclusion in clinical trials; disparities in cancer risk and treatment among the LGBTQ population; cancer prevention and screening in adolescents and young adults; precision oncology in diverse populations; financial toxicity for cancer patients; the impact COVID-19 has had on patients with cancer; diversifying the cancer research workforce; and more. 
What to expect: Research Highlights
The meeting organizers identified a number of key studies discussing the science of cancer health disparities.
|The Science of Cancer Health Disparities in Racial/Ethnic Minorites and the Medically Underserved|
|Epigenetic disruption of vitamin D receptor signaling in African American prostate cancer alters circadian signaling networks||The study found that the vitamin D receptor transcriptional signaling, which plays a role in prostate cancer development, is more dynamic in African men than in European American men, and that this signaling is disrupted in the prostate cancer cells of African American men. This disruption, mediated by altered expression of certain proteins and vitamin D3 levels, alter the regulation of circadian rhythm process and inflammatory signals.||Moray Campbell, Ph.D.|
The Ohio State University
|Impact of race on the uterine microbiome in women with early stage endometrial cancer||African American (AA) women have a higher mortality rate from endometrial cancer than non-Hispanic white (NHW) women. The study examined the uterine microbiome to find clues to this disparity and found higher microbial diversity in the endometrial cancers of AA women, compared with NHW women, and distinct microbial composition in these two populations.||Gabrielle Hawkins, M.D.|
University of North Carolina
|Patient-reported out-of-pocket costs and financial toxicity during early-phase oncology clinical trials||The study found that among cancer patients participating in early-phase cancer clinical trials, financial toxicity is disproportionally higher in those with lower income and those who travel farther. Unexpected medical costs were more common among minorities, and out-of-pocket costs were often substantial and unexpected. The study highlights the need to focus on reasons for the disparities in clinical trial participation.||Ryan Huey, M.D.|
The University of Texas MD Anderson Cancer Center
|Disparities in microsatellite instability/mismatch repair biomarker testing for patients with advanced colorectal cancer||Colorectal cancers that test positive for the biomarker microsatellite instability-high/mismatch repair deficiency (MSI/MMR) are eligible for treatment with an immune checkpoint inhibitor, and studies show improved outcomes with this treatment approach; however, this study, which examined data from the National Cancer Database, found that the MSI/MMR test is underutilized in patients who were older, of Black non-Hispanic race/ethnicity, uninsured or Medicaid-insured, or diagnosed at community programs.||Bryan Iorgulescu, M.D.|
Dana-Farber Cancer Institute
|All-cause and cause-specific mortality among Medicaid-insured women with preexisting type 2 diabetes diagnosed with breast cancer: A cancer registry-Medicaid linkage||This study found that among Medicaid-insured women diagnosed with breast cancer, those with preexisting type 2 diabetes had increased risk of all-cause, cancer-specific, and cardiovascular-specific mortality compared with nondiabetic women. Further, compared with women prescribed metformin, all-cause mortality risk was elevated among women prescribed sulfonylurea or insulin.||Wayne Lawrence, DrPH|
University at Albany, State University of New York
|Survey of healthcare providers in the ECOG-ACRIN cancer research Group: Attitudes, knowledge, and practice behaviors about LGBTQ patients with cancer||This study conducted a web-based survey of members of the ECOG-ACRIN Cancer Research Group to measure attitudes and knowledge about LGBTQ health and to study institutional practices for collecting data on sexual orientation and gender identity. Data showed limited knowledge among caregivers about LGBTQ health and cancer needs, but high interest in receiving education. Stratification by licensure/terminal degree (MD/DO vs. RN/NP/PA) revealed differences in willingness to be listed as an LGBTQ-friendly provider and in knowledge level about LGBTQ health needs.||Matthew Schabath, Ph.D.|
Moffitt Cancer Center
|Prenatal proximity to agricultural use of endocrine-disrupting pesticides and risk of testicular germ cell tumor (TGCT) among Latino and non-Latino adolescents in California||The incidence of testicular germ cell tumors (TGCTs) has increased steadily in the United States in recent years, especially among Latinos. This study assessed the association between TCGT diagnosis and agricultural application of 22 endocrine-disrupting pesticides using California’s Pesticide Use Reporting database within a 3km-radius of participants’ birth address in the year prior to birth. Acephate, an organophosphate insecticide, was associated with an increased risk for TGCT, possibly contributing 5-10 percent to the prevalence of TGCT among Latinos in California.||Scott Swartz|
University of California, Berkeley, and the University of California, San Francisco
 AACR Cancer Disparities Progress Report 2020: Achieving the Bold Vision of Health Equity for Racial and Ethnic Minorities and Other Underserved Populations [Report]
Featured Image: Philadelphia, PA – The AACR 2015 Annual Meeting – Photo courtesy © AACR Todd Buchanan. Used with permission.