African-Americans still more likely to die from cancer

Drops in smoking may have helped drive cancer death rates down among black men during the last decade, but they are still more likely to die of cancer than whites, according to a new analysis.

“I think we see some really good news, but then we also see some trends that are going in the wrong direction,” said Carol DeSantis, the study’s lead author from the American Cancer Society (ACS) in Atlanta.

Using information from several databases, the researchers analyzed information on the number of cancers diagnosed and the number of cancer deaths reported across the U.S. between 1990 and 2009.

The biennial analysis found that improvements in cancer treatments and care have avoided nearly 200,000 cancer deaths in blacks since 1990.

But cancer death rates for blacks are still higher than whites, according to DeSantis and her colleagues, who published their findings in CA: A Cancer Journal for Clinicians on Tuesday.

Between 2005 and 2009, the researchers found about 288 black men died from cancer out of every 100,000, compared to about 217 white men. Among women, those numbers were about 181 blacks per 100,000, and 155 whites per 100,000.

The gap between cancer death rates narrowed the most between black and white men during the last decade, according to the researchers. Over that time, the cancer death rate for black men fell by 2.4 percent every year, compared to 1.7 percent for white men.

“That’s primarily driven by declines in lung cancer, which is driven by more black men stopping smoking than white men,” said DeSantis.

For women, however, death rates fell equally between blacks and whites over the last decade at about 1.5 percent.

ACCESS TO CARE

The researchers also found black women are 16 percent more likely to die from cancer even though they are 6 percent less likely to get cancer.

“Primarily the reason for the lower incidence rate is that (blacks) are at a lower risk of lung and breast cancer… Then we see if you’re diagnosed with the cancer you’re more likely to die from the disease, and that’s truly an access to care issue,” said DeSantis.

“This is a mix of good and bad,” cancer disparity researcher Dr. Christopher Lathan, who was not involved with the new analysis, told Reuters Health.

“We are making some progress in cancer treatment and we’re narrowing the gaps, but there are still areas that need work,” said Lathan, director for the Cancer Care Equity Program at the Dana-Farber Cancer Institute in Boston.

David Wetter, professor in the Department of Health Disparities Research at The University of Texas MD Anderson Cancer Center in Houston, said the new numbers show that healthcare professionals and public health officials still need make an effort to reach out to underserved populations.

“Underserved, marginalized populations are the very last to benefit,” Wetter, who was not involved with the analysis, told Reuters Health.

“Unfortunately, as treatments improve and newer treatments are coming out, we will see a widening disparity if people don’t have equal access,” said DeSantis.

SOURCE: CA: A Cancer Journal for Clinicians, online February 5, 2013

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Cancer statistics for African Americans, 2013

Abstract

In this article, the American Cancer Society estimates the number of new cancer cases and deaths for African Americans and compiles the most recent data on cancer incidence, mortality, survival, and screening prevalence based upon incidence data from the National Cancer Institute, the Centers for Disease Control and Prevention, and the North American Association of Central Cancer Registries and mortality data from the National Center for Health Statistics. It is estimated that 176,620 new cases of cancer and 64,880 deaths will occur among African Americans in 2013. From 2000 to 2009, the overall cancer death rate among males declined faster among African Americans than whites (2.4% vs 1.7% per year), but among females, the rate of decline was similar (1.5% vs 1.4% per year, respectively). The decrease in cancer death rates among African American males was the largest of any racial or ethnic group. The reduction in overall cancer death rates since 1990 in men and 1991 in women translates to the avoidance of nearly 200,000 deaths from cancer among African Americans. Five-year relative survival is lower for African Americans than whites for most cancers at each stage of diagnosis. The extent to which these disparities reflect unequal access to health care versus other factors remains an active area of research. Overall, progress in reducing cancer death rates has been made, although more can and should be done to accelerate this progress through ensuring equitable access to cancer prevention, early detection, and state-of-the-art treatments. CA Cancer J Clin 2013;


Carol DeSantis MPH,
Deepa Naishadham MA, MS,
Ahmedin Jemal DVM, PhD

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