Revista de medicina pulmonar

Falling short: The NCI SPORE and missing omics

Robert Winn

When considering lung cancer and lung cancer disparities, there are several complexities including behaviors, social factors, difficulties with early detection, environmental factors, and biology. Disparities research often looks into race, ethnicity, and gender, but geography is also overwhelmingly a determinant of outcome. In 1992, the National Cancer Institute created Specialized Programs of Research Excellence (SPORE) to focus on particular organ sites in an effort to move basic science into clinical settings and to determine a biological basis for observations made in individuals with cancer and at-risk populations. Both are meritorious and have contributed to progress, but they fall short when not recognizing “place and space.” There is an intersectionality of what is called a neighborhood of association and effects on an individual’s biology. Neighborhood of association also adds to the level of an individual’s medical mistrust and willingness to pursue care.