Health disparities in cancer care

According to estimates, there will be over two million new cancer cases diagnosed in the U.S. in 2025. Every single one of those people (and those who’ve been diagnosed in the past) would probably agree on this fact: cancer is a life-changing diagnosis.

But despite that similarity, every patient’s cancer journey is unique. From their ability to receive an accurate diagnosis to their access to necessary treatment, each person will have an entirely different experience.

Some people will catch their cancer at an early stage and move forward with innovative and targeted interventions. Some will struggle to receive any diagnosis at all and, when they do, will struggle with limited access to treatment programs. And others will fall somewhere between those two ends of the spectrum.

Equity in healthcare is an ongoing issue—and you can see distinct health disparities in cancer care, specifically. Let’s take a closer look at these imbalances and their meaningful impact on a person’s cancer journey.

What are health disparities?

The Centers for Disease Control and Prevention (CDC) defines health disparities as “preventable differences in the burden of disease, injury, violence, or in opportunities to achieve optimal health experienced by socially disadvantaged racial, ethnic, and other population groups and communities.”

Put simply, different groups of people experience different healthcare access and outcomes—and these differences are frequently unequal and unjust.

Factors that could contribute to health disparities

Inequity is one of the most significant challenges facing the healthcare industry. And it’s not just a persistent issue—it’s a complicated one, largely because there are many different reasons for healthcare inequities. These factors include:

• Socioeconomic: Income inequality, education gaps, and lack of health insurance can limit access to early detection, preventive care, and timely treatment.
• Geographic: The U.S. has an uneven distribution of medical resources. This means rural populations often face significant barriers to care, including limited access to specialists, long travel distances, and higher exposure to environmental risks like pollutants.
• Biological and genetic: Certain types of cancer are more prevalent in specific racial or ethnic groups due to genetic predispositions. For example, Black people have higher new cancer rates for prostate, colon, and rectum cancers compared to other groups.
• Implicit bias: Whether intentional or not, health professionals can hold prejudices against people based on race, gender, and other factors, which can affect treatment recommendations and patient outcomes.

To complicate things even further, there’s a lot of overlap between these factors—a person can deal with several (or all) of these barriers at once. For example, a Black person in a low-income area of rural Alabama will likely experience health inequalities related to all of the above factors.

Health disparities in cancer incidence and diagnoses

There are many different disparities across the entire cancer journey—and that starts with incidence and diagnoses. Let’s take a look at a few of the prevalent disparities that researchers have identified and the factors that influence them.

Race is perhaps one of the biggest roots of the disparity in who gets cancer and receives an accurate and timely diagnosis. Compared to white women, Black women have higher cancer incidence rates for all major types of cancer, with the exception of breast cancer and lung cancer.

Yet, despite the high incidence rates, Black people are the least likely of all races to receive an early-stage diagnosis of cancers that have a recommended screening and the most likely to have a late-stage diagnosis, at which point the cancer is often more complicated to treat.

While they can be closely entwined with race, socioeconomic factors also play a major role in cancer incidence and diagnosis. People living in poverty have high rates of cancers caused by occupational, recreational, or lifestyle exposures. And, looking at lung cancer specifically, people with family annual incomes of less than $12,500 had incidence rates that were almost double the lung cancer incidence rate of people with incomes of $50,000 or higher.

Geography plays another major role, as the incidence of early-onset cancers isn’t distributed evenly across the U.S. Kentucky and West Virginia had the highest overall and advanced-stage incidence rates of early-onset cancer and, as further evidence that these factors are often interwoven, they’re also two states with some of the highest rates of poverty in the country.

Disparities in cancer treatment

If and when people do receive a cancer diagnosis, disparities persist in their access to care. And, again, these disparities exist across a variety of factors and barriers.

For example, people in rural areas have trouble accessing the high-quality cancer care they need and often need to rely on their primary care providers who aren’t equipped to provide specialized cancer treatment.

Poverty comes into play here too, particularly when it comes to a person’s ability to access cancer clinical trials. People who have lower socioeconomic status are significantly less likely to participate in these clinical trials, meaning they don’t have the same access to cutting-edge and potentially life-saving cancer treatments.

Of course, there are also racial disparities in cancer treatment. Take the surgical management of cancer as just one example. Surgery is a crucial step for the treatment of many different types of cancer, particularly those that are associated with high mortality.

However, minority patients are more likely to receive their cancer care in public or “safety net” hospitals (which are legally required to provide care to patients regardless of their ability to pay). These medical centers are far less likely to have surgical oncology programs, which limits patients’ ability to move forward with surgical interventions for their cancer.

Disparities in cancer outcomes and survival rates

When healthcare disparities mean people receive later diagnoses and lower-quality treatment, it makes sense that there are also inequalities in their cancer outcomes. Here’s a brief look at the disparities in treatment results and survival rates based on several different factors:

• Geographic: People living in rural areas have higher cancer mortality than those who live in urban areas, with the highest cancer death rates occurring in the South and Appalachia regions of the U.S.
• Race: Cancer death rates are highest among Black people and lowest among Asian Pacific Islander (API) populations.
• Socioeconomic status: Lower income generally translates to worse cancer outcomes. Cancer mortality was 11 to 50% higher in persistent poverty counties than in non-persistent poverty counties.

Cancer is a life-changing diagnosis—regardless of who you are, where you live, or what you earn. When that experience is so universal, every person who is diagnosed with cancer deserves affordable, convenient, and high-quality care.

Unfortunately, that’s not yet the norm in our medical system. There are still profound health disparities in cancer care. But there’s good news ahead: the healthcare field is actively working to reduce these cancer care inequalities. When experts and researchers combine awareness with action, they can lead us to a future where everyone can access the care they need.

And here’s some good news: Carrum’s Cancer Care program eliminates many of the health equity-related barriers people face when trying to get cancer care. Our members pay little to nothing for care, and they all receive treatment at the top-quality cancer centers in the country—regardless of their income level, race, ethnicity, or place of residence.

Learn more about Carrum’s value-based cancer program.

The information contained on this page is for informational purposes only. No material is intended to be a substitute for professional legal or medical advice, diagnosis, or treatment.