barriers to quality health care (15). Cancer is the leading cause of death in the U.S. Hispanic population, the second largest racial or ethnic group in the continental United States and Hawaii, whereas heart disease is the leading cause of death in the nonHispanic White population (16). Researchers are increasingly recognizing the heterogeneity in cancer burden among individuals within each of the major racial or ethnic minority groups (13). As one example, the U.S. Asian population has ancestry in numerous countries of origin and the Native Hawaiian or other Pacific Islander (NHOPI) population comprises more than 25 diverse subgroups with distinct variations in historical backgrounds, languages, and cultural traditions. Striking disparities in cancer death rates between NHOPI and Asian individuals have been identified since national death certificates included a new racial classification system which separated NHOPI individuals from Asian individuals, two populations that are frequently aggregated in cancer epidemiological data (17). These findings highlight the vital importance of disaggregated cancer data to fully understand cancer disparities and develop effective strategies for achieving health equity. In addition to racial or ethnic minorities, many other segments of the U.S. population shoulder a disproportionate burden of cancer (see Sidebar 2, p. 17). These include residents in rural areas that lack access to cutting-edge cancer treatments and/or state-of-the-art health care facilities, sexual and gender minorities who experience bias and discrimination in health care settings, and low-income households where there is persistent poverty, and limited access to healthy food or the needed health care. It should Which U.S. Population Groups Experience Cancer Disparities? According to the National Cancer Institute, cancer disparities are adverse differences in cancer such as the number of new cases and deaths, cancer-related health complications, quality of life after cancer treatment, financial burden, screening rates, and stage at diagnosis that are shouldered by certain population groups including: Individuals belonging to certain ancestry, racial or ethnic minority populations Individuals of low socioeconomic status Individuals who lack or have inadequate health insurance coverage Residents in certain geographic locations, including rural areas Individuals belonging to sexual and gender minorities Immigrants, refugees, or asylum seekers Individuals with disabilities Adolescents and young adults Older adults Adapted from (13). PASSPORT PASSPORT 65+ SIDEBAR 2 Cancer in 2023 AACR Cancer Progress Report 2023 17
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