DNA and "ZNA" Are Driving Cancers in Black Americans

The reasons behind disparity in cancer cases aren't black and white. There's more at play than genetics in why Black Americans have more aggressive tumors younger.
https://www.webmd.com/cancer/cancer-in-context/video/winn-cancer-disparity?src=soc_yt

-- TRANSCRIPT --
[MUSIC PLAYING] JOHN WHYTE: Welcome, everyone. I'm doctor John Whyte. I'm the chief medical officer at WebMD. When it comes to cancer, there is a lot of good news in terms of there's been decreases in certain cancers, but there's also been some concerning news, especially for Black Americans, who typically get more aggressive cancers and at an earlier age. So to help understand this, I've gone to one of the best experts I know. Dr. Robert Winn is the director of the VCU Massey Comprehensive Cancer Center. Dr. Winn, thanks for joining me.

ROBERT WINN: John, as always, thank you for having me. And I appreciate your paying attention to this subject and appreciate your body of work. Thank you, sir.

JOHN WHYTE: And we've known each other for many years. I won't say how many. And you have always been passionate about this concept of disparate care, even when other people weren't talking about it. And I found this recent study rather concerning because here, as I mentioned, we have some good news about certain types of cancer. But then for most cancers, we're seeing this increase, as I talked about and more aggressive, which is really concerning. So I have to ask you, do we have a good idea of what's causing it?

ROBERT WINN: Yeah, well, you know, the wonderful part about that is that I think that we are getting better in understanding. I think 20, 30 years ago, the answer was simple. It was that, well, there are African Americans and clearly it's just the genes.

I think over the last 30 years, we've come to recognize that place and space actually matters, that the ZNA actually has an impact on the DNA-- that is your Zip Code, Neighborhood, Associatio-- and give you an example. That if you take a 57-year-old woman-- white woman with breast cancer from Mississippi, their outcomes actually are poorer than a 57-year-old white woman from Massachusetts. It could be somewhat genetic, but there are multiple things at play.

In addition to the genes, there's also what happens in the environment-- stress, access to food, microbiome, these types of deals-- that are also having an impact on the biology. I think 30 years ago we would just kept it, pun intended, black and white and very simple and that we would say that African Americans clearly have a genetic component. That's what's driving this.

I think in 2024, not so simple. I think there's an element of certainly genetic, but our responses to stress and other things within our environment-- in our structured environment-- that also is a component that we hadn't accounted for when it comes to why African Americans have cancers at younger ages and why they're more aggressive. So I think we're in an age where we are finally understanding that they-- that the science is now starting to, I think, be able to get some clues as to why this is happening.

Transcript in its entirety can be found by clicking here:
https://www.webmd.com/cancer/cancer-in-context/video/winn-cancer-disparity?src=soc_yt