Similarities in Risk for COVID-19 and Cancer Disparities

Clin Cancer Res. 2021 Jan 1;27(1):24-27. doi: 10.1158/1078-0432.CCR-20-3421. Epub 2020 Oct 13.

Abstract

Coronavirus disease 2019 (COVID-19) is a novel infectious disease that has spread worldwide. In the United States, COVID-19 disproportionately affects racial and ethnic minorities, particularly African Americans, with an observed 2-fold higher rate for hospitalization and greater than 2-fold higher rate for death as compared with White Americans. The disparity seen with COVID-19 is consistent with patterns of disparities observed for cancer; it is well documented that 5-year survival rates for multiple cancers are lower in African Americans compared with White Americans. Root cause contributions for the disparity overlap between COVID-19 and cancer. While cancer is a genetic disease that is influenced by tissue microenvironment, COVID-19 is an infectious disease that is enabled by cellular expression of angiotensin-converting enzyme 2 receptors. However, socioeconomic disadvantages, level of education, lifestyle factors, health comorbidities, and limited access to medical care appear to fuel underlying risk for both cancer and COVID-19 disparities. In addition to African Americans demonstrating higher risk of acquiring and dying from either disease, they are underrepresented in clinical trials involving cancer or COVID-19. Long-term disparities are present with survivorship from cancer and may be likely with survivorship from COVID-19; both have revealed untoward effects on postdiagnosis economic viability for African Americans. Collaborative strategies that include community engagement, diverse participation in cancer and COVID-19 clinical trials, providing insurance for affected persons who lost employment due to either disease, and supporting safety-net and public hospitals for health care access will be critical to stem these disparities.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Angiotensin-Converting Enzyme 2 / metabolism
  • Black or African American / statistics & numerical data
  • COVID-19 / ethnology
  • COVID-19 / prevention & control*
  • COVID-19 / virology
  • Female
  • Genetic Predisposition to Disease / genetics
  • Health Services Accessibility / statistics & numerical data
  • Health Status Disparities*
  • Hospitalization / statistics & numerical data
  • Humans
  • Male
  • Neoplasms / ethnology
  • Neoplasms / genetics
  • Neoplasms / prevention & control*
  • Risk Factors
  • SARS-CoV-2 / isolation & purification*
  • SARS-CoV-2 / physiology
  • Tumor Microenvironment / genetics
  • White People / statistics & numerical data

Substances

  • ACE2 protein, human
  • Angiotensin-Converting Enzyme 2