Some Minorities Believe They Are Less Likely to Get Cancer Compared to Whites, Moffitt Cancer
Researchers at Moffitt Cancer Center and colleagues analyzed national data to investigate the differences in cancer prevention beliefs by race and ethnicity. They found that minorities, including blacks, Asians and Hispanics, have differing beliefs about cancer prevention and feel they are less likely to get cancer than did whites. The researchers concluded that more culturally relevant information about cancer prevention and risk needs to reach minority populations.
Their study appears online in the American Journal of Health Promotion.
“The purpose of our study was to determine if there were racial and ethnic differences in the general beliefs and perceptions about cancer and cancer prevention,” said study lead author Jenna L. Davis, M.P.H, research coordinator for Moffitt’s Health Outcomes and Behavior Program. “We used the Health Belief Model, a theory that explains an individual’s process for engaging in a certain health behavior or not based on their personal beliefs or perceptions.”
The researchers assessed participants’ beliefs regarding their risk of getting cancer, severity of cancer, and the benefit of detecting cancer early. They were also asked about their ability to prevent cancer and their understanding of screening and detection.
“We found that blacks, Asians and Hispanics were all more likely to believe that they had a lower chance of getting cancer than did whites,” said study senior author B. Lee Green, Ph.D., senior member of the Health Outcomes and Behavior Program at Moffitt. “This is significant and surprising because statistics show that racial and ethnic minorities, especially blacks, have higher cancer mortality, incidence and prevalence rates than whites and also differ from whites in engaging in preventive behaviors.”
Hispanics were also less likely than whites and blacks to believe that they could lower their chances of getting cancer. Regardless of race or ethnicity, participants felt that it was difficult to know which cancer prevention
recommendations to follow.
Black Women Had Worse Breast Cancer Mortality Regardless of Cancer Subtype
Black women with breast cancer had significantly worse survival compared with other racial and ethnic groups across cancer subtypes, which suggests that the survival differences are not solely attributable to the fact that black women are more frequently diagnosed with less treatable breast cancer subtypes, according to data presented at the AACR Annual Meeting 2013, held in Washington, D.C., April 6-10.
“The results seem to indicate that although African-American women are more likely to be diagnosed with less treatable subtypes of breast cancer compared with white women, it is not the only reason they have worse breast cancer mortality,” said Candyce Kroenke, M.P.H., Sc.D., research scientist at Kaiser Permanente Division of Research in Oakland, Calif.
Kroenke and colleagues examined the link between race and breast cancer survival in a prospective cohort of 1,688 breast cancer survivors enrolled in the Life After Cancer Epidemiology and Pathways study. The survivors had been treated for luminal A, luminal B, basal-like or HER2-enriched breast cancer.
The researchers obtained participants’ self-reported race information from mailed questionnaires. They tested samples of the patients’ tumors to determine their molecular subtype of cancer.
“There is a need for consistent cancer prevention messages and screening recommendations, as well as opportunities to increase education on cancer prevention among all populations,” Green said. “These efforts will make individuals feel more empowered to participate in cancer preventive behaviors.”
“African-Americans were more likely to have the hard-to-treat triple-negative breast cancer subtype and had a lower likelihood of having the luminal A subtype, which tends to be the most treatable subtype of breast cancer and has the best prognosis,” Kroenke said.
However, the researchers found that poor prognosis among blacks appeared consistent across breast cancer subtypes. Compared with white women, black women were 2.3 times more likely to die from the luminal A breast cancer subtype, 2.6 times more likely to die from the luminal B subtype, 1.3 times more likely to die from the basal-like subtype and 2.4 times more likely to die from the HER2-enriched subtype.
“African-Americans with breast cancer appeared to have a poorer prognosis regardless of subtype,” Kroenke said. “It seems from our data that the black-white breast cancer survival difference cannot be explained entirely by variable breast cancer subtype diagnosis.”
Given the racial and ethnic disparity in beliefs about cancer prevention when compared to whites, the researchers concluded that their study should encourage researchers and health practitioners to design cancer education and prevention interventions that are culturally relevant for racial and ethnic minorities to better educate them about cancer susceptibility and risk.
The great news is that overall cancer death rates have steadily decreased for African American men and women. In fact, the most recent data show that death rates dropped faster for African American men than men in any other racial or ethnic group. That’s caused the disparity in cancer death rates between African American and white men to shrink considerably. Cancer death rates among African American women are declining at a similar rate as those of white women.
Despite these declines, however, death rates for all cancers combined remain 33% higher in black men and 16% higher in black women, compared to white men and women. African American men also have higher death rates for most of the major cancer sites (including lung, prostate, colon/rectum, liver, pancreas, and others). Notably, the higher overall cancer death rate in African American women compared to white women occurs despite lower incidence rates for all cancers combined and for breast and lung cancer.
Cancer Statistics about African Americans Released
February 04, 2013
By Carol DeSantis, MPH
“Research on how risk information is communicated to various racial and ethnic groups, and how these groups react to cancer risk messages, is also needed,” Davis concluded.
Key Points
The National Cancer Institute (NCI) defines “cancer health disparities” as adverse differences in cancer incidence (new cases), cancer prevalence (all existing cases), cancer death (mortality), cancer survivorship, and burden of cancer or related health conditions that exist among specific population groups in the United States.
Complex and interrelated factors contribute to the observed disparities in cancer incidence and death among racial, ethnic, and underserved groups. The most obvious factors are associated with a lack of health care coverage and low socioeconomic status.
Although cancer deaths have declined for both Whites and African Americans/Blacks living in the United States, African Americans/Blacks continue to suffer the greatest burden for each of the most common types of cancer.
American White women have the highest incidence rate for breast cancer, although African American/Black women are most likely to die from the disease
African American/Black men have the highest incidence rate for prostate cancer in the United States and are more than twice as likely as White men to die of the disease.
NCI is pursuing a variety of programs and initiatives to address cancer health disparities. In 2001, the Center to Reduce Cancer Health Disparities (CRCHD) was established to serve as the cornerstone of NCI’s efforts to reduce the unequal burden of cancer in our nation.
About Moffitt Cancer Center
Located in Tampa, Moffitt is one of only 41 National Cancer Institute-designated Comprehensive Cancer Centers, a distinction that recognizes Moffitt’s excellence in research, its contributions to clinical trials, prevention and cancer control. Since 1999, Moffitt has been listed in U.S. News & World Report as one of “America’s Best Hospitals” for cancer. With more than 4,200 employees, Moffitt has an economic impact on the state of nearly $2 billion.
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Florida Science Communications