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Cardio-Oncology Preventive Care: Racial and Ethnic Disparities

  • Race and Ethnicity Disparities (M. Albert and L. Brewer, Section Editors)
  • Published:
Current Cardiovascular Risk Reports Aims and scope Submit manuscript

A Correction to this article was published on 01 January 2022

This article has been updated

Abstract

Purpose of Review

As cancer screening and treatment continue to improve, the number of cancer survivors is growing rapidly. Cardiovascular disease is the leading cause of death in cancer survivors. In this review, we explore racial and ethnic disparities in cardiovascular toxicity from cancer therapies, with a particular focus on prevention. In addition, we propose potential solutions to address these disparities.

Recent Findings

Multiple studies have found that African Americans experience higher rates of cardiotoxicity from chemotherapy than Caucasians. Few studies have explored reasons for these disparities. Social determinants of health and disparities in cardiotoxicity screening and surveillance, as well as risk factor incidence and management, are likely among underlying mediators. Studies about prevention of cardiotoxicity with dexrazoxane, beta blockers, angiotensin-converting enzyme (ACE) inhibitors, statins, and lifestyle modification were reviewed. In published studies, racial/ethnic minorities were generally underrepresented with racial or ethnic demographic information entirely missing in most studies.

Summary

Addressing critical health disparities in cardio-oncology will require a multidisciplinary approach. Minorities are continually underrepresented in clinical trials. Improving awareness of health disparities among providers, cultural competency training, and the implementation of quality measures to standardize care have the potential to reduce the impact of explicit and implicit bias leading to inferior care for racial/ethnic minorities. Increasing access to cardio-oncology providers in low socioeconomic areas has the potential to improve rates of screening and surveillance. Future applications of precision medicine and innovation in preventive cardio-oncology should be carefully designed and disseminated to alleviate and not worsen disparate care.

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Authors and Affiliations

  1. Department of Internal Medicine, University of California Davis Health, Sacramento, CA, USA

    Pooja Prasad

  2. Heart and Vascular Center of Excellence, Wake Forest Baptist Health, Winston Salem, NC, USA

    Mary Branch

  3. Academic Department of Internal Medicine, North Shore University Hospital and Long Island Jewish Medical Center, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Manhasset, NY, USA

    Daniel Asemota

  4. Department of Internal Medicine, Englewood Health, Englewood, NJ, USA

    Razan Elsayed

  5. Cardio-Oncology Program, Division of Cardiology, Ohio State University Medical Center, Columbus, OH, USA

    Daniel Addison

  6. Division of Cancer Prevention and Control, Department of Internal Medicine, College of Medicine, Ohio State University, Columbus, OH, USA

    Daniel Addison

  7. Cardio-Oncology Program, Division of Cardiovascular Medicine, Medical College of Wisconsin, 8701 W Watertown Plank Road, Wauwatosa, WI, 53226, USA

    Sherry-Ann Brown

  8. Department of Cardiovascular Diseases, Mayo Clinic, Rochester, MN, USA

    Sherry-Ann Brown

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Prasad, P., Branch, M., Asemota, D. et al. Cardio-Oncology Preventive Care: Racial and Ethnic Disparities. Curr Cardiovasc Risk Rep 14, 18 (2020). https://doi.org/10.1007/s12170-020-00650-8

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