Similarities in Risk for COVID-19 and Cancer Disparities.
Similarities in Risk for COVID-19 and Cancer Disparities.
复制标题
DOI：
10.1158/1078-0432.ccr-20-3421
复制
发表时间：
2021-01-01
期刊：
影响因子：
--
通讯作者：
Carethers JM
中科院分区：
文献类型：
--
作者：
Newman LA;Winn RA;Carethers JM
2019冠状病毒病（COVID-19）是一种在全球范围内传播的新型传染病。在美国，COVID-19不成比例地影响少数种族和族裔，特别是非洲裔美国人，与白色美国人相比，住院率高出两倍，死亡率高出两倍以上。在COVID-19中观察到的差异与在癌症中观察到的差异模式一致;有充分证据表明，与白色美国人相比，非洲裔美国人的多种癌症5年生存率较低。COVID-19和癌症之间差异的根本原因是重叠的。虽然癌症是一种受组织微环境影响的遗传疾病，但COVID-19是一种通过血管紧张素转换酶2（ACE 2）受体的细胞表达而实现的感染性疾病。然而，社会经济劣势、教育水平、生活方式因素和健康共病，以及获得医疗服务的机会有限，似乎加剧了癌症和COVID-19差异的潜在风险。除了非裔美国人表现出更高的患上和死于任何一种疾病的风险外，他们在涉及癌症或COVID-19的临床试验中的代表性不足。癌症的生存率存在长期差异，COVID-19的生存率也可能存在长期差异;这两种情况都对非裔美国人诊断后的经济可行性产生了不利影响。包括社区参与、癌症和COVID-19临床试验的多元化参与、为因任何一种疾病而失业的受影响人员提供保险以及支持安全网和公立医院提供医疗服务在内的合作战略，对于消除这些差距至关重要。
Coronavirus disease 2019 (COVID-19) is a novel infectious disease that has spread world-wide. In the United States, COVID-19 disproportionately affects racial and ethnic minorities, particularly African Americans, with an observed two-fold higher rate for hospitalization and greater than two-fold higher rate for death as compared to White Americans. The disparity seen with COVID-19 is consistent with patterns of disparities observed for cancer; it is well-documented that 5-year survival rates for multiple cancers are lower in African Americans compared to White Americans. Root cause contributions for the disparity overlap between COVID-19 and cancer. While cancer is a genetic disease that is influenced by tissue microenvironment, COVID-19 is an infectious disease that is enabled by cellular expression of angiotensin converting enzyme 2 (ACE2) receptors. However, socioeconomic disadvantages, level of education, lifestyle factors and health co-morbidities, and limited access to medical care appear to fuel underlying risk for both cancer and COVID-19 disparities. In addition to African Americans demonstrating higher risk of acquiring and dying from either disease, they are under-represented in clinical trials involving cancer or COVID-19. Long-term disparities are present with survivorship from cancer and may be likely with survivorship from COVID-19; both have revealed untoward effects on post-diagnosis economic viability for African Americans. Collaborative strategies that include community engagement, diverse participation in cancer and COVID-19 clinical trials, providing insurance for affected persons who lost employment due to either disease, and supporting safety-net and public hospitals for healthcare access will be critical to stem these disparities.