Progress and Challenge Cancer Death Rates Dropping Among African-Americans, but Still High

While death rates from cancer continue to drop among African-Americans, the group continues to be diagnosed at more advanced stages and have lower survival rates at each stage of diagnosis compared to whites for most cancer sites.

The findings come from Cancer Facts & Figures for African Americans 2009-2010, the latest edition of a report produced every two years by the American Cancer Society.

The new report says death rates for all cancers combined have decreased faster in African-American men than in white men, primarily because of rapid declines in the death rates from lung and prostate cancers. While overall cancer death rates have also decreased among African-American women, they are dropping at a slower rate than among white women. The slower decline in African-American women is largely due to smaller decreases in breast and colorectal cancer death rates.

The report estimates that, among African-Americans in 2009, there will be about 150,000 new cases of invasive cancer diagnosed and more than 63,000 cancer deaths. The most commonly diagnosed cancers among African-American men will be prostate (34{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5}), lung (16{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5}), and colon and rectum (10{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5}).

Among African-American women, the most common cancers will be breast (25{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5}), lung (12{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5}), and colon and rectum (11{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5}). Cancer of the lung will be the most common cause of cancer death in both African-American men (31{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5}) and women (23{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5}), followed by prostate cancer in men (12{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5}) and breast cancer in women (19{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5}). Cancer of the colon and rectum and cancer of the pancreas are expected to be the third- and fourth-most common causes of cancer death in both men and women.

“African-Americans have the highest death rate of any racial and ethnic group in the U.S. for most cancers,” said Dr. Otis Brawley, the American Cancer Society’s chief medical officer. “As this report points out, the causes of these disparities are complex and likely reflect social and economic disparities, not biologic differences.

“African-Americans face inequalities in income, education, and standard of living, as well as barriers to accessing high-quality health care. And while it is discouraging that these differences still exist, we absolutely must face them and continue to enact policies to address them in order to save lives and reduce suffering from cancer among African-Americans.”

Although the overall racial disparity in cancer death rates is decreasing, in 2005, the death rate for all cancers combined continued to be 33{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} higher in African-American men and 16{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} higher in African-American women than in white men and women, respectively.

Further Findings

The report determined that cancer death rates are lower among more educated African-Americans compared to those with less education. However, at each level of education, African-Americans have higher death rates than whites.

According the National Health Interview Survey in 2006, almost half of African-American adults reported no leisure-time physical activity, compared to 35{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} of whites. Physical activity has been associated with lower risk of cancers of the breast, colon, prostate, and endometrium.

According to the most recent data (2005-06) from the National Health and Nutrition Examination Survey, 76{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} of African-Americans adults are overweight, and 46{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} are obese, compared to 66{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} and 33{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5}, respectively, of whites.

Only half of African-American women age 40 and older reported getting a mammogram within the past year, slightly less than the 53{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} of whites. In addition, 40{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} of African-Americans reported a recent colorectal cancer screening test in 2005, compared to 50{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} of whites.

On the plus side, African-American boys and girls, among whom smoking rates have been decreasing since the late 1990s, have lower smoking rates than any other racial/ethnic group.

The report also includes highlights of American Cancer Society efforts to save lives and eliminate disparities in cancer morbidity and mortality. In 2006, the ACS built on a long history of research and programs designed to understand and describe the impact of health disparities, and to implement and advocate for evidence-based strategies to reduce or eliminate them, by launching an ambitious effort to address inequities in cancer prevention services, access to care, incidence, and mortality.

Since 1999, the American Cancer Society has funded 106 studies totaling $87 million devoted to the poor and medically underserved. Forty-two percent of this research focuses on the African-American population, encompassing the cancer continuum from helping people stay well through prevention efforts to helping people get well through programs and hands-on support for survivors. In addition, the society’s internal research departments focus substantial resources on disparities research.

The American Cancer Society Cancer Action Network (ACS CAN), the society’s advocacy affiliate, is also working to address these issues by encouraging elected officials and candidates to make cancer a top national priority. ACS CAN helps to create, change, and influence public policies that can have a significant impact on reducing cancer disparities in this country.

David Sampson is director of Medical & Scientific Communications for the American Cancer Society.