Consideration of Race, Ethnicity and Ancestry

Should race, ethnicity and ancestry be used as universal proxies for genetic, social and socioeconomic issues related to otolaryngology conditions?

Background: Historically, race, ethnicity and ancestry have been associated with otolaryngology conditions such as nasopharyngeal carcinoma, otosclerosis, acoustic neuroma, sickle cell anemia, Burkitt’s lymphoma and skin malignancies. Advances in genetics could help otolaryngologists move beyond these markers and facilitate the development of more exact, tailored therapeutic interventions.

Setting: Division of Otolaryngology, University of Cape Town, South Africa.

Synopsis: For race-based studies to have merit, the authors said the terms “black” and “white” need to be accurately defined and measured. For example, in Africa, people with African features are considered “black.” In New Zealand, the term is applied to Maori and those with aboriginal ancestry. In order for the terms “black” and “white” to be universally applicable, they should be biologically defined, because skin color alone is a poor proxy for a person’s genetic profile. The connection between skin color and ancestry is relatively inaccurate, especially where people of different ancestry have mixed extensively. An analysis of genetic variants has shown that skin color is not associated with the percentage of a person’s recent African ancestors, and most people who classify themselves as African American have some European ancestry.

Bottom line: Race, ethnicity and ancestry are inadequate universal proxies for genetic, social and socioeconomic issues.

Citation: Fagan JJ, Fagan FJ. Is otolaryngology black and white? Laryngoscope. 2011;121(9):1826-1827.

—Reviewed by Sue Pondrom