The tragic deaths of George Floyd, Tony McDade, Breonna Taylor, Sean Reed, Ahmaud Arbery, and other victims of racist violence sparked outrage and protests across the United States and around the world and cast a harsh light on the systemic injustices that made such atrocities possible. These systemic injustices also pervade the community of cancer scientists, clinicians, health care professionals, and patients, creating significant health inequities among racial and ethnic minorities.

• Statements against Racial Discrimination and Inequality. As protests occurred across the United States during the summer following the murder of George Floyd, the AACR released a statement against racial discrimination and inequality. The statement was signed by the AACR officers—2019-2020 President Elaine R. Mardis, PhD, FAACR, 2020-2021 President Antoni Ribas, MD, PhD, FAACR, President-Elect Designate David A. Tuveson, MD, PhD, FAACR, Immediate Past President Elizabeth M. Jaffee, MD, FAACR, Treasurer and Past President William N. Hait, MD, PhD, FAACR, and Chief Executive Officer Margaret Foti, PhD, MD (hc)—as well as MICR Council Chair John D. Carpten, PhD, and it noted that the AACR “stand[s] in solidarity against racial discrimination and inequality, and will work with our diverse membership to help create a world that achieves equity, unity, and justice for all.”
  
  Under the leadership of Dr. Carpten, the MICR Council released its own statement condemning the violence and noting that racial inequity is also a public health crisis. The council pledged that the AACR would “dedicate its efforts to the elimination of cancer health disparities and the inclusion and recognition of the contributions of minority investigators in cancer research.”

• Virtual AACR Annual Meeting II: Panel Discussion on Racial Inequality in Cancer Research. Following up on the AACR’s statement against racial discrimination and inequality, 2020–2021 AACR President and Annual Meeting Program Chair Antoni Ribas, MD, PhD, FAACR, convened and moderated a panel discussion during the Virtual Annual Meeting to stimulate an open and frank discussion about the corrosive effect of racial inequity on the cancer community and to outline the concrete steps the AACR can take to eliminate the effects of inequity on cancer patients as well as scientists, clinicians, and health care professionals.
  
  The panel featured Black, Hispanic, and Native American cancer scientists and leaders from cancer centers, pharmaceutical companies, and governmental agencies: Russell J. Ledet, PhD, a medical student who established a group called the 15 White Coats in an effort to help young Black children see themselves as a potential part of the medical community; Robert Winn, MD, director of the Virginia Commonwealth University Massey Cancer Center; Lola A. Fashoyin-Aje, MD, MPH, deputy division director of the Division of Oncology 3 in the Office of Oncologic Diseases at the FDA; Levi Garraway, MD, PhD, chief medical officer and head of global product development at Genentech/Roche; Hannah Valantine, MD, MRCP, first chief officer of Scientific Workforce Diversity and Senior Investigator at the NIH; Marcia Cruz-Correa, MD, PhD, director of the Gastrointestinal Oncology Division at the Dr. Isaac Gonzalez Martinez Oncologic Hospital and professor at the University of Puerto Rico Comprehensive Cancer Center; Kenneth Frazier, chief executive officer of Merck & Co.; Judith S. Kaur, MD, professor of oncology and the medical director for Native American Programs in the Mayo Clinic Cancer Center; and John D. Carpten, PhD, director of the Institute of Translational Genomics and Professor at the University of Southern California Keck School of Medicine. Over the course of the 90-minute session, the panelists discussed several ways to address racial injustice in cancer research, including:
  • Building a more diverse cancer workforce in academia, industry, and government institutions to ensure that patients of all races and ethnicities are considered in the development of new treatments.
  • Expanding access to cancer care to eliminate the disproportionate cancer burden experienced by minorities and other underrepresented groups. This increased access must include prevention and early detection, as minorities are often diagnosed with cancer at an advanced stage, when treatment is less likely to be effective.
  • Increasing minority representation in clinical trials to ensure that treatments are safe and effective for all racial and ethnic groups. Trial organizers should partner with minority investigators to build trust in underrepresented communities, and trial designers should explore restructuring trials to eliminate criteria that might exclude potential minority participants.

• New AACR Task Force on Eliminating Racial Inequities in Cancer Research. To further support the work of MICR, and to ensure that the recommendations made by the panel at the Virtual AACR Annual Meeting II are translated into action, the AACR Board of Directors decided to establish a task force to focus specifically on racial inequities in cancer research. The task force will be chaired by John M. Carethers, MD, MACP, and Melissa B. Davis, PhD, and its roster and charge will be finalized in early 2021.

• AACR Cancer Disparities Progress Report. For the last ten years, the AACR Cancer Progress Report has highlighted research-driven advances in the prevention, detection, diagnosis, and treatment of cancer and made the case for sustained, predictable funding for the NIH, the NCI, and the FDA. During that time, the field of cancer health disparities research has evolved from descriptive studies of outcomes among populations into an established multidisciplinary field of research. In September 2020, the AACR addressed a critical need in the field with the publication of the AACR Cancer Disparities Progress Report. In the inaugural edition of this report, the steering committee—chaired by Dr. Carpten—highlights areas of progress in addressing the challenge of cancer health disparities and emphasizes the need for continued research and increased collaboration among stakeholders in order to achieve the bold vision of health equity.

• The report—which was unveiled at a Virtual Congressional Briefing on September 16—illuminates the many complex components of cancer health disparities, including social, clinical, behavioral, cultural, psychological, environmental, and genetic and biological factors. However, because most data on cancer biology and risk are derived from white individuals of Western European ancestry, the steering committee notes the urgent need for more research on the genes and mutations associated with cancer in racial and ethnic minorities.
  
  The report points out that the most important contributing factor to cancer health disparities is access to care, as innovations in cancer treatment are not equally distributed across all populations. It highlights a number of recent studies showing that racial and ethnic disparities in outcomes for several types of cancer could be eliminated if every patient had equal access to standard treatment. The report concludes with a call to action to Congress and to all stakeholders in the cancer community to take the following steps to eliminate health inequities:
• Provide robust, sustained, and predictable funding increases for the federal agencies and programs that are tasked with reducing cancer health disparities.
• Implement steps to ensure that clinical trials include a diverse population of participants.
• Support programs to make sure that our health care workforce reflects and appreciates the diverse communities it serves.
• Prioritize cancer control initiatives to reduce the incidence, morbidity, and mortality of cancer and to improve quality of life for all cancer patients and survivors.

• AACR Conference on The Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved. The thirteenth edition of this long-standing AACR conference—which was held virtually October 2-4—was especially timely in light of the increased focus on health inequities in 2020. Chaired by Dr. Carpten and organized in association with the MICR Council, the conference featured a keynote address by NIH Director Francis Collins, MD, PhD. Dr. Collins noted that the COVID-19 pandemic has exposed and exacerbated the problem of health inequities in the United States, as COVID-19—like cancer—has disproportionately affected minority populations. He applauded the AACR Cancer Disparities Progress Report for calling attention to the gaps in health equity in the U.S. and noted that the NIH will consider the findings in the report as it works to eliminate those gaps.

• A major topic of discussion at the conference was prostate cancer in African American men, who are 1.8 times more likely to be diagnosed with the disease and 2.2 times more likely to die from it than white men. Several speakers explored the question of whether biology plays a role in these poorer clinical outcomes, investigating a number of biological pathways to identify alterations that contribute to health disparities. However, a review of the social influences on prostate cancer outcomes revealed inequities in screening, access to care, and the receipt of treatment across the continuum of prostate cancer progression that amplify the effects of these biological factors—implying that prostate cancer outcomes in African American men could be significantly improved by eliminating these inequities.

• Travel Awards: Diversifying the Cancer Workforce. For more than 30 years—with the generous support of the Center to Reduce Cancer Health Disparities of the NCI—the AACR has fostered the pipeline of cancer scientists and clinicians by supporting career opportunities for racial/ethnic minority groups that have been traditionally underrepresented in cancer and biomedical research:
• AACR Minority Scholar in Cancer Research Awards. Since 1985, the AACR has supported the Annual Meeting attendance of full-time graduate and medical students, residents, and clinical and postdoctoral fellows from underrepresented groups who have submitted meritorious proffered papers. Through networking opportunities and exposure to the cutting-edge Annual Meeting program, these early-career scientists lay the foundation for promising careers in cancer research.
• AACR Minority and Minority-Serving Institution (MMSI) Faculty Scholar in Cancer Research Awards. Since 1997, this program has provided an Annual Meeting experience to full-time minority faculty and faculty of Minority-Serving Institutions who have submitted meritorious proffered papers. The awards are designed to expand the knowledge base of the faculty, to foster their career advancement, and to support them in inspiring their students to pursue careers in cancer research.

• Addressing Inequities through Research Funding. The AACR made progress in 2020 toward reducing cancer health disparities and promoting diversity in the cancer workforce through new funding mechanisms:
• AACR-Genentech Cancer Disparities Research Fellowships. These fellowships—which were established in 2019 and were awarded again in 2020—are intended to encourage postdoctoral or clinical fellows to conduct cancer disparities research and to establish a successful career path in this field. The two-year, $120,000 grants support basic, translational, clinical, or epidemiological research that has direct applicability and relevance to cancer disparities.
• Breast Cancer Research Foundation-AACR Career Development Awards to Promote Diversity and Inclusion. These two-year, $150,000 grants—which were established in 2020 and will be awarded beginning in 2021—were launched to support breast cancer investigators from diverse backgrounds that are underrepresented in cancer science-related research and to foster their career advancement.
• Lustgarten Foundation-AACR Career Development Awards for Pancreatic Cancer Research, in Honor of Rep. John Robert Lewis. These three-year, $300,000 grants—which will be awarded beginning in 2021—were established in 2020 to inspire progress against pancreatic cancer. Named in honor of the 17-term U.S. representative and civil rights icon, the awards will support investigators from racial or ethnic groups that have been shown to be underrepresented in the cancer-related sciences workforce.