Findings Reveal Gaps in Care For Pregnant Minority Women With Cancer: Duke Appiah, PhD, MPH

In part 2 of an interview with The American Journal of Managed Care®, Duke Appiah, PhD, MPH, associate professor at Texas Tech University Health Sciences Center, expands on the findings of his abstract, "Higher Risk of Adverse Pregnancy Outcomes Among Racial and Ethnic Minority Women With Cancer in the US," which he presented earlier this week at the American Association for Cancer Research Annual Meeting 2025.

Building on these findings, he discusses how clinicians can better support pregnant minority women with cancer and highlights key areas for future research.

Watch part 1 to learn more about the abstract's key takeaways.

This transcript has been lightly edited; captions were auto-generated.

Transcript

Your findings showed that adverse pregnancy outcomes were more common among racial and ethnic minority women with cancer. What do you think is driving these disparities?

Most of the things that drive health disparities in most diseases will be at play here. For instance, pre-existing conditions, like hypertension and diabetes, even before pregnancy, also exacerbate the occurrence of these adverse pregnancy outcomes.

Some studies have reported, again, isolated studies, that even the treatment itself that a woman receives during, let's say, pregnancy for cancer, can also influence some of the adverse pregnancy outcomes. With these factors, taking into account other factors, such as socioeconomic status, can all play a role in some of these findings that we have reported.

But then the good news is, again, this is also to help people explore more of the differences that even within the same race or the same ethnicity, just having cancer really elevates your risk for advanced pregnancy outcomes.

We put out data to also stimulate more findings and more investigations. From the broad view, I would say some of these factors that we have known to predispose racial and ethnic groups to a higher incidence of cancer are some of the driving factors.

What are the most immediate steps clinicians can take to better support pregnant patients with cancer from racial and ethnic minority groups?

Currently, the guidelines are not so comprehensive, and so physicians are doing their very best, and I've always said I will support that, and I'm just providing them with information, that is, my team and I. We are providing them with information to make more informed decisions.

For instance, knowing that, let's say, an African American woman or a Hispanic woman have in common, let's say, just pre-existing diabetes. Just on the onset, you know that they are going to have a higher risk. For instance, 4 out of 10 women with cancer from racial and ethnic minority groups are likely to have 1 of the adverse pregnancy outcomes. This is to inform physicians, to let them know, and also to inform patients to make decisions.

The thing about it is we studied a wide, comprehensive range of adverse pregnancy outcomes to help in making the decisions, and we represented all racial and ethnic groups. Based on some of this data, at least women and pregnant individuals can make some decisions whether to go on with the pregnancy, or what type of treatment to even seek during pregnancy when they have cancer.

Lastly, are there any unanswered questions or areas for future research that you're particularly interested in exploring?

I would say yes. For instance, again, looking at the type of treatment, even the change in modalities of treatment during pregnancy, and how that affects adverse pregnancy outcomes, is an area of interest of mine that I need to explore.

Again, I mentioned some of the factors that we know lead to disparities in cancer outcomes. I would like to study, see, and also quantify how each of them contributes to these disparities that we see in pregnant individuals who have cancer.