A groundbreaking study presented at the American Association for Cancer Research Annual Meeting 2025 has revealed significant disparities in pregnancy outcomes among racial and ethnic minority women with cancer, highlighting critical gaps in care that require urgent attention.
The research, led by Duke Appiah, PhD, MPH, associate professor at Texas Tech University Health Sciences Center, found that women from racial and ethnic minority groups who have cancer during pregnancy face substantially higher risks of adverse outcomes compared to white women in similar situations.
Higher Risks Across Multiple Outcomes
The comprehensive analysis examined a wide range of pregnancy complications, including hypertensive disorders, gestational diabetes, fetal growth restriction, intrauterine fetal death, preterm birth, and maternal mortality. Across nearly all these metrics, women from racial and ethnic minority backgrounds demonstrated elevated risk profiles.
"Four out of ten women with cancer from racial and ethnic minority groups are likely to have one of the adverse pregnancy outcomes," noted Dr. Appiah, underscoring the magnitude of the disparity.
The study found particularly concerning patterns for specific cancer types. Women with breast cancer and thyroid cancer showed approximately 30% higher risk of pregnancy complications compared to their counterparts without cancer. This finding has significant implications for treatment planning and pregnancy management in these populations.
Multifactorial Causes of Disparity
Dr. Appiah identified several potential drivers behind these disparities, pointing to a complex interplay of factors that extend beyond cancer itself.
"Most of the things that drive health disparities in most diseases will be at play here," he explained. "Pre-existing conditions like hypertension and diabetes, even before pregnancy, also exacerbate the occurrence of these adverse pregnancy outcomes."
The research team also noted that cancer treatments themselves may contribute to pregnancy complications, though this relationship requires further investigation. Socioeconomic factors likely play a significant role as well, consistent with broader patterns of healthcare disparities in the United States.
Clinical Implications and Guidance
The findings arrive at a critical time when clinical guidelines for managing cancer during pregnancy remain incomplete. Dr. Appiah emphasized that the research aims to provide physicians and patients with more comprehensive information to support decision-making.
"Currently, the guidelines are not so comprehensive, and physicians are doing their very best," Dr. Appiah acknowledged. "We are providing them with information to make more informed decisions."
For clinicians, the research suggests the need for heightened vigilance when caring for pregnant minority women with cancer, particularly those with pre-existing conditions. The data may help inform decisions about pregnancy continuation, treatment selection, and monitoring protocols.
Maternal Mortality Concerns
Perhaps most alarming among the findings was the elevated maternal mortality rate observed across all racial and ethnic groups with cancer compared to those without cancer—with minority women facing the highest absolute risk.
This finding highlights the critical importance of specialized, multidisciplinary care for pregnant cancer patients, with particular attention to the needs of women from minority backgrounds.
Future Research Directions
Dr. Appiah identified several important areas for future investigation, including the impact of different treatment modalities during pregnancy on maternal and fetal outcomes.
"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," he stated.
Additionally, the research team plans to quantify how various social determinants of health contribute to the observed disparities, potentially identifying targeted intervention points.
Addressing a Critical Research Gap
Prior to this study, research on obstetric complications in women with cancer had notable limitations. Previous investigations typically focused on specific outcomes like preterm birth without comprehensively examining racial and ethnic differences.
Dr. Appiah's work addresses this gap by providing data that reflects all major racial and ethnic groups in the United States, offering valuable information for shared decision-making between patients and their healthcare teams.
"Having cancer, getting pregnant, and going to deliver a baby is a very complicated situation, which needs multifactorial factors to be included," Dr. Appiah emphasized. "Shared decisions have to be made between different specialties."
The findings underscore the need for personalized approaches to cancer care during pregnancy that account for the unique risks faced by women from different racial and ethnic backgrounds, potentially improving outcomes for this vulnerable population.
