Recent data exposed systemic racial disparities across the full spectrum of cancer care.
New real-world data, published by the American Society of Clinical Oncology, found racial disparities in when patients started treatment and how oncologists prescribed pain medication. Researchers found that Black patients with breast cancer waited over two weeks longer (about 80 days) than White patients (about 65 days) to receive their first pain medication. Asian patients were more likely to start treatment sooner, but were least likely to receive stronger opioids. Only 28% received stronger opioid prescriptions, compared with 32% of Black patients and 35% of White patients.
The racial disparities in treatment care only narrowed in pancreatic cancer, which has clinical guidelines that more closely standardize pain management.
The study was led by Ontada researcher Ila Sruti, who explained the results did not examine the drivers for the racial disparities. However, he asserted the findings may suggest standardized care can help reduce gaps.
“From our perspective, this reinforces the idea that standardized care pathways can help reduce variability, but there still may be additional opportunities to ensure more consistent, equitable pain management across all groups of patients,” Sruti said.
Racial Disparities Persist In Cancer Diagnosis, Treatment And Survival
Today, Black, American Indian, and Alaska Native populations continue to experience some of the highest cancer mortality rates in the country. Many disparities begin before treatment starts, according to KFF. Some racial and ethnic groups are more likely to have cancers detected at later stages, which is when they are harder to treat.
In 2025, the Centers for Disease Control and Prevention published a blog post outlining how racism contributes to cancer health disparities. The agency acknowledged that “racism limits the ability of people of racial and ethnic minority groups to prevent cancer, find cancer early and get treatment.”
Black Communities
According to the American Cancer Society, Black men and women experience among the highest cancer burdens. Black men face higher prostate cancer diagnosis rates, and are more likely than White men to die from colorectal and liver cancer.
Black women are about 40% more likely to die from breast cancer than White women, despite having lower overall breast cancer incidence rates. Similarly, Black women receive more diagnoses of aggressive breast cancers and later-stage disease.
Black women receive nearly half of endometrial cancer diagnoses at an advanced stage, compared with 30% of cases among White women. The American Cancer Society reports that Black women are also less likely to receive timely, guideline-recommended treatment after diagnosis.
Native Americans and Alaska Native
Native American and Alaska Native communities also face significant burdens in cancer mortality and treatment.
Research shows these populations experience higher rates of early-onset colorectal and stomach cancers. They also face higher mortality rates for several cancer types compared with other racial and ethnic groups.
Although many Native communities receive care through the Indian Health Service and tribal health programs, many patients report delayed diagnosis and treatment.
Per-patient spending by the Indian Health Service lags behind other federal health systems. This has contributed to the ongoing workforce shortages, limited specialty services and geographic barriers within the health system.
The Cost Of Survival Largely Depends On Access
Insurance remains a major barrier to routine cancer screenings, specialized care and certain treatment types. The National Cancer Institute describes this phenomenon as “financial toxicity,” which is the distress caused by out-of-pocket medical costs.
Many innovative, next-generation treatments, genomic sequencing and biomarker testing remain cost prohibitive without comprehensive health insurance.
Underrepresented groups are less likely to receive personalized cancer treatments, including targeted molecular therapies tailored to tumor genetics. Studies also show underrepresented patients are more likely to report negative financial impacts, like treatment debt and depleted savings, from cancer treatment.
Oncologists Cost Concern Shape Prescribing
Financial concerns and assumptions about a patient’s ability to pay also influence oncologist decisions. Back in 2024, a study published in A Journal of Clinical Oncology found that 47% of 1,049 oncologists surveyed considered a patient’s insurance coverage very important when making treatment decisions.
The Department of Health and Human Services advises cost discussions should be patient-centered rather than based on physician assumptions on a patient’s ability to pay. However, research suggests conversations are still being shaped by assumptions. In one survey, 16% of oncologists acknowledged omitting treatment options because they believed a patient could not afford them.
Federal Focus Has Shifted Away From Reducing Racial Gaps In Oncology Outcomes
While cancer mortality in the U.S. has fallen over the past three decades, data still shows uneven progress in diagnosis, survival outcomes and treatment experiences across racial and ethnic groups.
At one point, reducing these gaps was seemingly a federal priority. In 2023, the National Cancer Institute launched the National Cancer Plan, which identified eliminating cancer disparities as a key goal. The federal Cancer Moonshot initiative, originally launched during the Obama administration and renewed under the Biden administration, also prioritized reducing cancer inequities, through expanded screening, access and treatment resources.
In recent years, federal health priorities have shifted away from some equity-focused initiatives and frameworks. In 2025, the National Institutes of Health froze and canceled hundreds of millions of dollars in research funding, affecting projects focused on health disparities, minority populations and diversity-related health research.
Oncology Groups Quietly Continue Inititatives
Despite the decline in federal focus on health equity initiatives, several oncology organizations are still cautiously moving forward with efforts to reduce cancer disparities. Organizations, like the the National Comprehensive Cancer Network and the American Cancer Society, are using research, policy and clinical programs to breakdown the issue.
The National Comprehensive Cancer Network
The NCCN develops evidence-based cancer treatment guidelines used by physicians, health systems and insurance providers. Recent updates have included efforts to improve language and incorporate health equity considerations.
In its 2026 programming report, NCCN highlighted its Health Equity Report Card pilot program. The program is being tested at five academic cancer centers before expanding into community settings. NCCN has also launched a policy initiative focused on supporting cancer care equity and improving access to treatment.
The American Cancer Society
The American Cancer Society has focused on self funding studies and releasing datasets on factors driving cancer disparities. Its Cancer Disparities Research Team examines how social determinants of health contribute to differences in cancer outcomes across the U.S.
These initiatives reflect a growing recognition that medical innovation alone cannot eliminate cancer disparities. However, ensuring equitable outcome in oncology will require collaboration among researchers, oncologists, healthcare systems, policymakers and communities.
