Impact of Structural Racism and Social Determinants of Health on Disparities in Breast Cancer Mortality.

Autor:	Falcone M; USC Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California, Los Angeles, California., Salhia B; USC Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California, Los Angeles, California.; Department of Translational Genomics, Keck School of Medicine, University of Southern California, Los Angeles, California., Hughes Halbert C; USC Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California, Los Angeles, California.; Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, California., Roussos Torres ET; USC Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California, Los Angeles, California.; Division of Oncology, Department of Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California., Stewart D; USC Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California, Los Angeles, California.; Division of Oncology, Department of Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California., Stern MC; USC Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California, Los Angeles, California.; Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, California., Lerman C; USC Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California, Los Angeles, California.
Jazyk:	angličtina
Zdroj:	Cancer research [Cancer Res] 2024 Dec 02; Vol. 84 (23), pp. 3924-3935.
DOI:	10.1158/0008-5472.CAN-24-1359
Abstrakt:	The striking ethnic and racial disparities in breast cancer mortality are not explained fully by pathologic or clinical features. Structural racism contributes to adverse conditions that promote cancer inequities, but the pathways by which this occurs are not fully understood. Social determinants of health, such as economic status and access to care, account for a portion of this variability, yet interventions designed to mitigate these barriers have not consistently led to improved outcomes. Based on the current evidence from multiple disciplines, we describe a conceptual model in which structural racism and racial discrimination contribute to increased mortality risk in diverse groups of patients by promoting adverse social determinants of health that elevate exposure to environmental hazards and stress; these exposures in turn contribute to epigenetic and immune dysregulation, thereby altering breast cancer outcomes. Based on this model, opportunities and challenges arise for interventions to reduce racial and ethnic disparities in breast cancer mortality. (©2024 American Association for Cancer Research.)
Databáze:	MEDLINE
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