Kristin M. Primm

Advances in cancer prevention, early detection, and treatment have led to substantial improvements in cancer outcomes in the United States over the past several decades. Despite this progress, these gains have not been equitably distributed, and many populations continue to experience a disproportionate burden of cancer. Persistent disparities, rooted in structural inequities, social disadvantage, and unequal access to health care, remain a major challenge to achieving health equity. The American Association for Cancer Research (AACR) Cancer Disparities Progress Report 2026 highlights both the progress made toward reducing cancer disparities and the critical gaps that remain. Addressing these disparities will require coordinated efforts across research, clinical care, public health, and policy to ensure that advances in cancer science benefit all populations. See AACR Cancer Disparities Progress Report 2026 .

On December 4, 2025, the American Association for Cancer Research (AACR) released its inaugural AACR Pediatric Cancer Progress Report, which highlights the remarkable scientific and clinical advances transforming outcomes for children (ages 0–14) and adolescents (ages 15–19) with cancer. This first-of-its-kind report encompasses progress against pediatric cancers made over the past decade and chronicles major developments in molecularly targeted therapies, immunotherapies, and genomic profiling that are reshaping pediatric cancer diagnosis, surveillance, and treatment. The report also underscores the enduring challenges that impede progress, including the lack of effective therapies for rarer and aggressive pediatric cancers and the persistent inequities in access to high-quality treatment and supportive care, both in the United States and worldwide. Collectively, these insights reaffirm the urgent need for increased federal investment, strengthened international collaboration, and innovative research strategies to accelerate progress against pediatric cancer. The full report is freely available at PediatricCancerProgressReport.org.

Supplementary Figure from A Contemporary Analysis of Racial and Ethnic Disparities in Diagnosis of Early-Stage Breast Cancer and Stage-Specific Survival by Molecular Subtype

Background:Prior studies of breast cancer disparities have focused primarily on differences between Black and White women, yet contemporary patterns of disparity for other groups are not well understood. We examine breast cancer disparities by stage at diagnosis across nine racial and ethnic groups.Methods:The SEER 18 registries identified 841,975 women diagnosed with breast cancer from 2000 to 2017. Joinpoint models assessed trends in diagnosis stage and survival. Multivariable logistic regression evaluated associations between race/ethnicity and diagnosis stage. Multivariable Cox models compared survival of groups by stage and molecular subtype.Results:Black, American Indian, Southeast Asian, South Asian, Pacific Islander, and Hispanic women were less likely than white women to be diagnosed with early stage breast cancer. Among those diagnosed at early stage, Hispanic, American Indian, Pacific Islander and Black women were 9%, 14%, 22%, and 39% (respectively) more likely than White women to die from breast cancer, whereas Asian subgroups had lower risk of death. Among those diagnosed at late stage, Black women were 18% more likely than White counterparts to die from breast cancer, and survival disparities for Black women persisted across all subtypes and stages, (except late stage HR−/HER2−). East Asian women with early stage HR+/HER2− tumors had better survival than White women.Conclusions:Persistent disparities in early detection and survival of breast cancer demand further work to address and reduce disparities across the cancer continuum.Impact:Results have implications for efforts to reduce entrenched racial and ethnic disparities in breast cancer early detection and survival.

Background: The Affordable Care Act expanded Medicaid coverage for people with low income in the United States. Expanded insurance coverage could promote more timely access to cancer treatment, which could improve overall survival (OS), yet the long‐term effects of Medicaid expansion (ME) remain unknown. We evaluated whether ME was associated with improved timely treatment initiation (TTI) and 3‐year OS among patients with breast, cervical, colon, and lung cancers who were affected by the policy.Methods: Medicaid‐insured or uninsured patients aged 40–64 with stage I–III breast, cervical, colon, or non‐small cell lung cancer within the National Cancer Database (NCDB). A difference‐in‐differences (DID) approach was used to compare changes in TTI (within 60 days) and 3‐year OS between patients in ME states versus nonexpansion (NE) states before (2010–2013) and after (2015–2018) ME. Adjusted DID estimates for TTI and 3‐year OS were calculated using multivariable linear regression and Cox proportional hazards regression models, respectively.Results: ME was associated with a relative increase in TTI within 60 days for breast (DID = 4.6; p < 0.001), cervical (DID = 5.0 p = 0.013), and colon (DID = 4.0, p = 0.008), but not lung cancer (p = 0.505). In Cox regression analysis, ME was associated with improved 3‐year OS for breast (DID hazard ratio [HR] = 0.82, p = 0.009), cervical (DID‐HR = 0.81, p = 0.048), and lung (DID‐HR = 0.87, p = 0.003). Changes in 3‐year OS for colon cancer were not statistically different between ME and NE states (DID‐HR, 0.77; p = 0.075).Conclusions: Findings suggest that expanded insurance coverage can improve treatment and survival outcomes among low income and uninsured patients with cancer. As the debate surrounding ME continues nationwide, our findings serve as valuable insights to inform the development of policies aimed at fostering accessible and affordable healthcare for all.

Background: There are well‐established disparities in colorectal cancer (CRC) outcomes between White and Black patients; however, assessments of CRC disparities for other racial/ethnic groups are limited.Methods: The Surveillance, Epidemiology, and End Results database identified patients aged 50–74 years with CRC adenocarcinoma from 2000 to 2019. Trends in age‐adjusted incidence rates were computed by stage at diagnosis and subsite across five broad race/ethnic groups (White, Black, Asian/Pacific Islander [API], American Indian/Alaskan Native [AIAN], and Hispanic) and four API subgroups (East Asian, Southeast Asian, South Asian, and Pacific Islander) Multivariable logistic regression evaluated associations between race/ethnicity and diagnosis stage. Multivariable Cox proportional hazards models assessed differences in cause‐specific survival (CSS).Results: Hispanic, AIAN, Southeast Asian, Pacific Islander, and Black patients were 3% to 28% more likely than Whites to be diagnosed with distant stage CRC, whereas East Asian and South Asians had similar or lower risk of distant stage CRC. From Cox regression analysis, Black, AIAN, and Pacific Islanders also experienced worse CSS, while East Asian and South Asian patient groups experienced better CSS. No significant differences in CSS were observed among Hispanic, Southeast Asian, and White patients. When stratified by stage, Black patients had worse CSS across all stages (early, hazard ratio (HR) = 1.38; regional, HR = 1.22; distant, HR: 1.07, p < 0.05 for all).Conclusion: Despite advances in CRC screening, treatment and early detection efforts, marked racial/ethnic disparities in incidence, stage at diagnosis, and survival persist. Findings demonstrate the extent to which aggregating heterogenous populations masks significant variability in CRC outcomes within race/ethnic subgroups.

We thank Drs. Bazan and Obeng-Gyasi (1) for their interest in our study (2) and we welcome this opportunity for further discourse. In their letter, they suggest that we extend our analysis by examining the study endpoints with the disaggregation of the Hispanic population by race. We agree with them that Hispanic women are a heterogeneous group, and a more granular analyses of racial disparities within Hispanic subgroups may provide additional insights into our finding of worse survival outcomes among Hispanic women with early-stage disease and across subtypes (except triple-negative disease).Although we agree regarding the importance of disaggregating racial and ethnic data in breast cancer research, small sample sizes and limited data availability (on Hispanic origin/subgroups) prohibited a more granular analyses of racial/ethnic disparities within Hispanic race and origin subgroups. For example, Hispanic Black persons comprised only 0.18% of the entire study population, Hispanic Asian women comprised 0.09% (n = 768), Hispanic American Indian/Native Alaskan women, and 0.03% (n = 216) identified as Hispanic Pacific Islander. The limited sample size of Hispanic race groups were a concern given our stratification of models by stage at diagnosis, further limiting the sample size needed to produce statistically reliable estimates. Moreover, because the Surveillance Epidemiology and End Results (SEER) database did not start recording HER2 status until 2010, analyses stratified by molecular subtype are limited to women diagnosed in 2010 and after, further constraining numbers available for analyses. Future studies should examine breast cancer disparities within the Hispanic population by race.Another important point made by Drs. Bazan and Obeng-Gyasi about analyzing Hispanic patients by country of origin, with which we also agree, is regrettably unfeasible as data on country of origin are not available from SEER. Given projected growth of Hispanic populations across the United States, investment in more meaningful data collection to facilitate disaggregation is a critical step in advancing health equity. Indeed, a key strength of the SEER resource, central to its mission, is its oversampling of specific groups in order to facilitate estimation of national trends in incidence, survival, and mortality rates for each group and comparison by group. However, current approaches for such sampling may require reconsideration as aggregating “Hispanics,” “Asians,” and other groups may exert an unintended structural bias that impedes careful evaluation of cancer health disparities instead of exposing it.See the original Letter to the Editor, p. 1867No disclosures were reported.This research and Drs. K.M. Primm and S. Chang are supported by the MD Anderson Cancer Center, and Drs. K.M. Primm and S. Chang are supported by an award from the Cancer Prevention and Research Institute of Texas (CPRIT) for the CPRTP Postdoctoral Fellowship in Cancer Prevention Program (RP 170259).