Black people are underrepresented in the oncology workforce in the United States, and although organizations have launched initiatives to promote diversity, there is more work to be done, according to experts.1-5

“About 14% of the US population, but only 3% of oncologists, are African American,” said Jame Abraham, MD, chairman of the department of hematology and medical oncology at the Cleveland Clinic in Ohio. 

“It is important to have appropriate representation of African Americans in the oncology workforce to build trust, address disparities, and improve mortality among African-American patients.” 

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To learn more about the lack of Black representation in oncology and actions that can be taken to increase representation, we interviewed Karen M. Winkfield, MD, PhD, executive director of the Meharry-Vanderbilt Alliance in Nashville, Tennessee, and author of articles on the topic.1,2,5 

Factors Contributing to Underrepresentation 

While there are numerous factors contributing to the lack of representation, Dr Winkfield explained that the issue is rooted in the overall lack of representation of Black people in science, technology, engineering, mathematics, and medicine (STEMM) careers. 

“The current US education system is steeped in racism, with resource allocation for early childhood education being tied to property taxes,” Dr Winkfield said. “Decades of redlining and other mandated and permitted practices that force segregation and systematically reduce wealth-building capacity for Blacks/descendants of slaves in the US have significantly hampered the ability to support the intellectual growth of students who may be in under-resourced communities.”

Dr Winkfield added that even when Black students do make their way into STEMM professions, they may experience limited exposure to oncology careers. None of the 4 historically Black colleges and universities in the United States has an oncology residency training program, and there are substantial costs involved in creating the necessary opportunities in the field. 

As Dr Winkfield and a colleague wrote in JAMA Oncology in 2018, students from groups who are underrepresented in medicine, including American Indian, Black, and Hispanic students, may be more likely to abandon the goal of becoming a physician due to the disproportionate financial burden they face.2

A greater number of underrepresented students have been found to carry premedical and medical school debt — and at higher amounts — compared with White and Asian students. For example, data have shown that Black students graduate with medical school debt exceeding $200,000 more often than other students.