Cancer-Specific Racial Disparities Persist Despite Overall Progress

A new report by the American Cancer Society points to disparities in cancer survival between whites and blacks for certain cancers, although the reasons for these differences remain unconfirmed.

Published in CA: A Cancer Journal for Clinicians, Cancer Statistics for African Americans, 2016, summarizes the most recent data on cancer incidence, mortality, survival, screening, and risk factors for cancers in African Americans in the United States. The report collated cancer incidence data from the National Cancer Institute, CDC, and the North American Association of Central Cancer Registries, while the source for the mortality data was the National Center for Health Statistics. Based on the information gathered, the report predicts 189,910 new cases of cancer and 69,410 cancer deaths among blacks in 2016.

While the overall progress—measured in terms of reduced mortality—is real across genders between blacks and whites, the report found an increase in the racial gap in death rates for breast cancer in women and has remained the same for colorectal cancer in men. However, death rates from lung, prostate, and colorectal cancer have reduced much faster among black than white women, thereby reducing the racial gap. The following are some of the findings from the report:

• The overall cancer death rate in males was 47% higher in blacks than in whites in 1990, but reduced to 24% higher in 2012. Among females, the disparity decreased from 19% higher in 1991 to 14% in 2012.
• Since 1990, breast cancer death rates dropped 23% in black women and 37% in white women. As a result, the racial disparity has widened. Breast cancer death rates in the most recent time period (2008-2012) are 42% higher in black women compared with white women, despite historically lower incidence rates.
• From 2003 to 2012, colorectal cancer death rates declined faster in black women than white women (3.3% vs 2.9% per year) but declines were slower in black men than in white men (2.5% vs 3.0%). As a result, the racial gap is shrinking in women, whereas rates in men have remained about 50% higher in blacks than in whites since 2005.
• The 5-year relative survival rate is lower in blacks than in whites for every stage of diagnosis for most cancer sites, most of which can be attributed to barriers that limit access to timely, appropriate, and high-quality medical care, resulting in advanced stage at diagnosis, when treatment choices are more limited and often less effective.
• In black men, incidence rates from 2003 to 2012 decreased by 2.0% per year for all cancers combined as well as for the top 3 cancer sites (prostate, lung, and colorectal).
• In black women, overall cancer incidence rates during this time remained unchanged, reflecting increasing trends in breast cancer countered by decreasing trends in lung and colorectal cancer rates.
• Obesity increases cancer risk, and black women have the highest body mass index (BMI) of any sex-racial/ethnic group. During 2013-2014, nearly 60% of black women were obese compared with nearly 40% of white women.

Explaining their findings, the report’s lead author Carol DeSantis, MPH, said in a press release, “While some studies suggest that blacks who receive cancer treatment and medical care similar to that of whites experience similar outcomes, others report that racial disparities persist even after controlling for socioeconomic factors and access to care. The bottom line is accelerating progress in eliminating racial disparities requires equitable access to services for prevention, early detection, and high-quality treatment.”