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Racial Disparities in Cancer Mortality Still Remain
  MedPage Today
February 05, 2011
Disparities in cancer mortality are falling overall for African Americans, although survival remains poorer than in any other racial or ethnic group for most cancer types, the American Cancer Society found.
The 2011-2012 outlook projected a narrowing of the gap in death rates from smoking-related cancers but increasing disparity in colorectal and breast cancers.
Socioeconomic status plays a critical role in continued disparities, although it is a multifaceted problem, Otis W. Brawley, MD, the society's chief medical officer, noted in a press release.
"African Americans are disproportionately represented in lower socioeconomic groups," he said. "For most cancers, the lower the socioeconomic status, the higher the risk."
Action Points
* Explain that the American Cancer Society reported that African Americans are still dying from cancer at a higher rate than all other racial/ethnic groups despite some decline in death rates for specific cancers.
* Point out that the society attributes racial disparity in cancer mortality rates to socioeconomic factors and use of medical services rather than to biological differences among races.
The report likewise blamed social and economic forces -- "inequities in work, wealth, income, education, housing, and overall standard of living, as well as barriers to high-quality cancer prevention, early detection, and treatment services" -- rather than biologic differences by race.
It also pointed to higher prevalence of risk factors, such as obesity among African-American women, and lagging use of mammography and colonoscopy screening tests among African Americans compared with whites.
Overall cancer incidence had been on the rise into the early 1990s but has since decreased at 1.6% per year in African-American men and stabilized in African-American women.
The death rate for all cancers combined was 32% higher for African-American men and 16% higher for African-American women than their white peers in 2007, the report noted.
Breast cancer accounted for 37% of the overall cancer mortality disparity between races in women. Death rates from breast cancer had been similar for African-American and white women in the early 1980s but by 2003-2007 were 39% higher for African Americans.
While the death rate from colorectal cancer has been on the decline among African Americans since 1985, a faster drop was seen among whites, leading to a growing gap since the early 1980s.
On the other hand, the report cited the benefits of declines in both smoking prevalence and initiation over the past four decades on smoking-related cancer deaths.
Disparities in lung cancer death rates among men dropped substantially, from in excess of 50% higher rates for African Americans compared with whites in the early 1990s to a 28% disadvantage in 2003-2007. For men under age 40, the disparity has been eliminated, which the report suggested was a result of faster declines in this group in both cancer deaths and smoking prevalence.
"If young African Americans continue to have low smoking prevalence as they get older, racial differences in lung cancer death rates should be eliminated among men in the next 40 to 50 years," the report projected.
Lung cancer death rates have held relatively steady among women since 1998.
The American Cancer Society estimated that 168,000 new cancer cases will be diagnosed and 65,540 cancer deaths will occur among African Americans in 2011.
In African-American men, prostate cancer is expected to account for the largest proportion of diagnoses (40%), followed by lung (15%) and colorectal cancers (9%). In African-American women, breast cancer is expected to lead at 34%, followed by lung (13%) and colorectal cancers (11%).
The American Cancer Society compiled the report based on published national data.
Primary source: American Cancer Society
Source reference:
"Cancer Facts & Figures for African Americans 2011-2012" ACS 2011.
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