Mariana C. Stern, PhD, discusses the biggest gaps identified in the 2026 AACR Disparities Progress Report and what oncologists can do to combat them.
Despite leaps and bounds of progress in narrowing societal gaps for cancer care, there is still considerable ground to be made as new gaps regarding access begin to widen for the oncology field, according to Mariana C. Stern, PhD.1
“The common thread that we see across most of these disparities is access. Access to screening, early detection, care, and clinical trials,” said Stern in an exclusive interview with OncLive®. “A key message is that disparities not only affect the communities that suffer them; they affect everyone.”
Stern is a professor of Clinical Population and Public Health Services, the Ira Goodman Chair in Cancer Research, associate director for Population Science at USC Norris Comprehensive Cancer Center, and vice chair for Culture and Engagement at the Keck School of Medicine of USC in Los Angeles, California.
Gaps in cancer mortality rates between Black and White patients have been a persistent disparity in cancer care, however, the report highlights this gap has narrowed from 34% higher mortality rate for Black patients in 1991 to just 9% in 2024. Moreover, since 2000, cervical cancer mortality rates between Hispanic and White women have also considerably narrowed.
“These accomplishments reflect the investments that were made in trying to understand those disparities and deploying initiatives and interventions to reduce them, further highlighting the importance of focusing on this field,” Stern explained. “[Reductions in cervical cancer mortality rates are] a great reflection of the progress that has been made in terms of understanding the root causes of these disparities and deploying initiatives to reduce them, which mainly have to do with increased vaccination and increased screening and early detection.”
Other notable disparities that have narrowed since 2000 include stomach cancer mortality rates between Asian or Pacific Islander and White populations in addition to lung cancer mortality rates between White and Black men.
“What [these narrowing disparities are] telling us is that the initiatives that have been put in place are working right now,” Stern added.
Effective initiatives and approaches in narrowing these disparities highlighted by the report include interventions tailored culturally and linguistically to marginalized groups, improved patient-navigation structures and platforms, activities and programs centered around promoting healthy behaviors among communities, and expanded access to health care via legislation and public policy.
Although lasting disparities in cancer between racial and ethnic groups have narrowed with recent progress, new ones have recently arisen.
“Black, American Indian, and Alaska Native communities still bear the greatest burden of cancer, with the highest overall cancer death rates compared with any other group in the US,” Stern highlighted. “These remain big disparities for these communities; a cross-cutting fact across all these diverse disparity communities is that every single racial and ethnic minority group has about a 5-year lower survival compared [with] White populations.”
Furthermore, divides between other groups such as gender and sexuality minorities and those who live in rural areas have begun to spread. “When we look at disparity populations, we not only look at racial and ethnic minorities, we also look at other disparity populations that include members that represent the entire country,” Stern explained.
For example, the report highlights how lesbian women are nearly twice as likely to be diagnosed with thyroid cancer or non-hodgkin lymphoma vs heterosexual women, rural residents have a 27% higher chance of dying from colorectal cancer vs urban residents, and cervical cancer mortality rates are 49% higher among women in countries with persistent poverty vs those in non-poverty persistent counties.
A particularly striking developing disparity that Stern and the report underscore is the rising early-onset colorectal cancer diagnosis in younger patients.
“The other emerging disparity that we see that is of great concern is that we see that early onset colorectal cancer is rising across all racial and ethnic groups. This is a diagnosis among very young people who don't qualify for screening. They're not being screened, which means that they typically tend to be diagnosed at an advanced stage because by the time they realize they have something, it’s because they have symptoms; then typically that goes along with a higher stage [in their diagnosis],” Stern added.
Structural changes for the field of oncology and society in general are pivotal in not only addressing the current disparities at hand but proactively preventing the engendering of new ones, according to Stern and the report. More granular data, analyses, and trials focused on all marginalized groups, and greater access to clinical trials and resources are but a few of the structural improvements that the field of oncology can make to bridge gaps in disparities.
“We need to continue collecting data, and we need to make those data as granular as possible so that we can identify the most pressing disparities… Providing access to care is a key barrier to address,” Stern said. “In terms of what we can do [in day-to-day practice to address disparities], we see that only a small percent of patients are participating in clinical trials. Clinical trials are the fastest way for patients to have access to more innovative drugs. We need to increase the number of patients who participate across the entire spectrum in the US.”
Stern also shed light on Venssa Bañuelos, a 34-year-old patient with acute lymphoblastic leukemia highlighted in the reports Survivor Spotlight. Stern explained how Banuelos’ diagnosis was unexpected, creating a stressful environment with limited resources for her to turn to and subsequently causing her to make difficult decisions regarding her fertility.
“Bañuelos was a young woman living her life, then she gets diagnosed, and all of this information comes to her. They discussed with her the issue of fertility and preserving her eggs before she underwent chemotherapy, but there was so much else going on, and the cost was so high to do any of these things… She's in remission, which is wonderful, but now she doesn't have her fertility anymore,” Stern said.
Bañuelos’ story speaks to the value of increased access and resources in not only narrowing disparities with younger patients but also improving their ability to live a normal life. Moreover, Stern turned to a study done at the Veterans Health Administration where patients who are veterans are provided increased access to the same quality of care and integrated systems and networks across all populations and experience similar outcomes.
Survivorship stories and studies solidify the efficacy of increasing access and other broader efforts to narrow cancer care disparities, but implementing these initiatives is often met with costly concerns. However, Stern and the report highlight how these initiatives might reduce costs and economic burdens rather than raise them.
“The cost to the US economy if we just focus on racial and ethnic inequities, the excess burden of cancer, death, cancer incidence driven by these disparities that we know exist [incur] a cost to the US economy that is over $400 billion per year; this is money that we could be saving if the disparities did not exist,” Stern emphasized. “It's not only a moral responsibility helping the communities that are suffering, but it's also a fiscal responsibility.”
On top of reducing costs, Stern argued that better representation and access to services such as clinical trials will also help make novel therapies more effective.
“We need to have representation in cancer research studies because those are the studies that lead to the development of new drugs that then are tested in clinical trials. If drugs are developed with cell lines and samples from patients that only represent one community in the US, then we are never going to understand how those drugs are going to perform in others,” she added. “We need to really ensure that we have representation, not just in clinical trials, but in basic cancer research.”
AACR Disparities Progress Report. June 24, 2026. Accessed August 5, 2026. https://cancerprogressreport.aacr.org/wp-content/uploads/sites/2/2026/06/AACR_CDPR_2026.pdf
