Addressing Systemic Disparities and Targeted Marketing in Cancer Care

In part 3 of an interview with Targeted Oncology, Rebecca Siegel, MPH, cancer epidemiologist and senior scientific director of surveillance research at the American Cancer Society (ACS), discusses the ACS Cancer Facts & Figures 2026 report, of which she was the lead author.

The American Indian and Alaska Native (AIAN) populations currently face the highest cancer mortality rates and the least favorable survival trends in the United States. A primary driver of this disparity is the high incidence of lung cancer, which is intrinsically linked to smoking rates that remain significantly higher than the national average. While public discourse often stigmatizes individuals with lung cancer, experts emphasize that these health outcomes are the result of predatory corporate strategies and systemic neglect rather than individual choice alone.

The Role of Targeted Marketing and Poverty

Tobacco companies have historically employed aggressive, highly calculated marketing tactics to target marginalized groups, including people of color, low-income communities, and those living on tribal reservations. This targeted advertising, combined with disproportionate levels of poverty and significant geographic barriers to healthcare, creates a cycle of addiction and late-stage diagnosis.

In many tribal regions, the geographic distance to specialized oncology centers is a prohibitive barrier. Furthermore, the Indian Health Service (IHS)—the federal agency responsible for providing health care to the AIAN population—is chronically and severely underfunded. This lack of resources means that many clinics are unable to offer even basic preventative services, such as routine breast cancer screenings or modern diagnostic imaging, leading to cancers being caught only in their most advanced, less treatable stages.

Disparities in the Black Population

Significant disparities also persist within the Black population, which experiences the second-highest burden of cancer mortality. This is most starkly illustrated in prostate cancer outcomes. Black men face a disproportionate risk, with death rates that are 2 to 4 times higher than those of any other racial or ethnic group.

While the biological reasons for the higher incidence of aggressive prostate cancer in Black men are not yet fully understood, the disparity in death rates is largely attributed to unequal access to high-quality care. When adjusted for equivalent access to treatment and early screening, these survival gaps often narrow, suggesting that the survival gap is a reflection of structural inequities in the healthcare delivery system rather than inherent biological differences alone. Addressing these outcomes requires not only medical innovation but also a concentrated effort to resolve the funding gaps in community-based health services.

REFERENCE

Siegel RL, Kratzer TB, Wagle NS, Sung H, Jemal A. Cancer statistics, 2026. CA Cancer J Clin. 2026;76(1):e70043. doi:10.3322/caac.70043