Identify and define a problem within the US
IntroductionBackground and SignificanceAccording to the United States Census Bureau (2017), Hispanics constitute 17.6 percent of the U.S. total population with a total of 56.6 million as of 2016. Hispanics are the largest minority group of the country, and are projected to have a growth rate of 2 percent for the next five years, yet they are significantly underrepresented in cancer clinical research. This underrepresentation is concerning given that Hispanics among other minority groups are affected by several health disparities including cancer (Pesquera, Yoder, Lynk, 2010). In fact, cancer is the leading cause of death among Hispanics living in the United States (CDC, 2017). According to the National Cancer Institute (2017), cancer health disparities occur among certain minority groups including Hispanics, which leads to a disproportionate incidence, mortality, cancer screening, and survival rate in certain types of cancers, such as prostate, colorectal, cervical, and breast cancer. Variations in cancer incidence between Hispanics and other groups are caused by differences in genetics, exposure to cancer causing infectious agents, rates of screening, and lifestyle patterns (National Institute of Health, 2017).As the Hispanic population continues to grow, it is imperative to close the gaps that exist in todays healthcare delivery system. Racial and ethnic minority populations are significantly underrepresented in cancer clinical research (Simon, De La Riva, Bergan, Norbeck, McKoy, Kulesza, Dong, Schnik, & Fleisher, 2014). Limited diversity in clinical research participation will yield results that do not fully portray the impact of cancer in minority populations (Tham, Hohl, Copeland, Briant, Marquez-Magana, & Thompson, 2016).Equitable clinical participation will ensure that clinical research findings will be more applicable to the U.S. population and will expand our scientific knowledge on why certain populations are more likely to develop cancer or why different populations react differently to certain cancer treatments (Rearden, Hanlon, Ulrich, Brooks-Carthon, & Sommers, 2016). Furthermore, with equitable clinical research participation, underrepresented groups will have higher chances to access potential life-saving treatments (Pesquera et al., 2010). Increasing diversity in cancer clinical trials will provide health professionals with an opportunity to reduce cancer health disparities and ensure the best chance for positive outcomes in cancer treatment and management across a broader patient spectrum.Moreover, the inclusion of minority groups such as Hispanics in cancer clinical research is well known to be of extreme importance as it will generalize research findings. Despite efforts from different organizations such as National Institute of Health [NIH], Food and Drug Administration [FDA], and Centers for Disease Control and Prevention [CDC], ethnic minority groups remain underrepresented in clinical cancer research (Martinez, Cummings, Karriker-Jaffe, & Chartier, 2017). Multiple barriers have been identified which prevent ethnic/minority groups in cancer clinical research participation. Different minority groups share many similar barriers that prevent them from participating in cancer clinical research, however others barriers are unique to specific population groups (George, Duran, & Norris, 2014). Recent research has shown successful recruitment strategies that have increased the willingness of different minority groups including Hispanics in participating in cancer clinical research. Thus, there is a need to understand and explore the barriers that hinder Hispanics from participating in cancer clinical research as well as recruitment strategies that have been implemented and are yielding successful results so that they may be implemented across the country.Problem StatementNew discoveries, advances, and breakthroughs made in cancer prevention and treatment over the last 3 decades have aided in the decline in incidence and mortality rate in certain cancers as well as an increase in survival rate (Siegel, Fedewa, Miller, Godin-Sauer, Pinheiro, Martinez-Tyson, & Jemal, 2015). However, recent data has shown that minority and underprivileged populations have significant higher incidence and mortality rates in certain types of cancer such as breast, prostate, and cervical cancer (Siegel et al, 2015). Many of the same population groups that experience cancer health disparities are also significantly underrepresented in cancer clinical trials (Simon et al., 2014). Cancer disparities and equity research is needed to understand why some groups of people may be more or less likely to develop cancer, experience cancer-related health problems, or die from cancer more often than other groups of people. An increase in the diversity of participants in clinical trials can ensure that trial findings are applicable to a broader patient population.Purpose StatementThe purpose of this literature review is to identify barriers preventing Hispanics from participating in clinical cancer research, as well as to identify resources being implemented that have increased the willingness of Hispanics to participate in clinical cancer research.Research QuestionThe following research questions will be discussed in this literature review:What are the barriers that prevent Hispanics from participating in cancer clinical research?What resources currently in place are increasing cancer clinical research participation among Hispanics?