Metastasis‐directed therapy plus hormone therapy improves progression‐free survival for advanced prostate cancer

9 © B A K H TI A R Z EI N / SH U TT ER ST O C K .C O M cancer accounted for 3% of new cancer diagnoses but 8% of cancer deaths. It is the fourth leading cause of cancer death in the United States. Dr Jemal notes that a major finding of the report was the persistent racial/ethnic disparities in cancer mortality despite continued progress in reducing overall cancer mortality in all populations. He points to the finding that mortality rates for breast cancer were 40% higher in Black women than White women despite Black women having a lower incidence rate, and myeloma mortality was twice as high in Black women in comparison with White women. Dr Jemal attributes these ongoing disparities in outcomes to differences in access to and receipt of high-quality care and to differences in insurance coverage. Of the 30 million people uninsured in the United States, he explains that a disproportionate number belong to non-White populations. “Insurance is both the gateway to the system of care and a major barrier to receipt of cancer care,” says Dr Jemal. A primary gap in care for these populations, given their lack of insurance, was accessing screening for common cancers, such as colonoscopies for colorectal cancer prevention and mammograms for breast cancer prevention. Dr Jemal notes that despite an uptick in screening for both cancer types over the past few decades, the increase in screening rates has slowed and plateaued. He partly attributes this to the lack of Medicaid expansion for low-income adults in many Southern and Midwestern states. “We continue to have these persistent disparities in the US largely because of inequitable application of knowledge in cancer prevention, early detection, and treatments,” Dr Jemal says, emphasizing the need for intensified advocacy efforts to expand Medicaid to low-income individuals in all states. “We need to further advocate for public policies such as improving access to care for all populations and increasing federal funding for research in order to reduce disparities and accelerate progress against cancer,” he notes.