The good news on cancer? According to the National Cancer Institute (NCI),
cancer incidence and mortality overall are declining in all population
groups in the U.S.—due in large part to impressive advances in diagnosis
and treatment as well as increased public awareness of the need for regular
screenings. The bad news? Minority populations – Blacks and African-Americans,
in particular – are still more likely to develop cancer and die
from the disease.
According to NCI statistics, significant health disparities exist within
these populations, especially when it comes to certain types of cancer:
- Blacks/African Americans in general have higher death rates than all other
racial and ethnic groups for many, although not all, cancer types.
- Black/African-American males have a higher mortality rate for prostate,
lung, colorectal, liver and pancreatic cancer, while Black/African-American
females have a higher death rate for breast and lung cancer.
- Although deaths from prostate cancer have dropped substantially in recent
decades among all men, Black/African-American men are twice as likely
as White men to die of prostate cancer and continue to have the highest
prostate cancer mortality among all U.S. population groups.
- Hispanic/Latino and Black/African-American women have higher rates of cervical
cancer than women of other racial/ethnic groups, with Black/African-American
women having the highest rates of death from the disease.
- Despite having similar rates of breast cancer, Black/African-American women
are more likely than White women to die of the disease.
Kerry-Ann McDonald, M.D., a breast surgical oncologist at
Lynn Cancer Institute in Boca Raton, part of Baptist Health South Florida, says that breast
cancer is the most common cancer diagnosed among Black women. And, she
adds, this group is far more likely to develop aggressive, advanced-stage
breast cancer.
“Not only are Black and African-American women more at risk for developing
breast cancer than any other type of cancer, they’re also twice
as likely to be diagnosed with triple negative and inflammatory breast
cancers,” says
Dr. McDonald. Of even more concern, she notes, is the fact that Black women also have
the highest breast cancer mortality of any racial or ethnic group in the
country. “A Black woman in the U.S. is 42 percent more likely to
die from breast cancer than a White women. That’s a shocking number—it
shouldn’t be that high.”
Health disparities are also evident in Hispanic/Latino populations, where
women diagnosed with breast cancer are often diagnosed at a younger age
than non-Hispanic White women. “With breast cancer, the median age
at diagnosis for Hispanic women is 59 years, compared to 63 years for
non-Hispanic white women,” Dr. McDonald says.
What are the causes of cancer health disparities?
Cancer disparities reflect the interplay among many factors, according
to the NCI. These include social determinants of health, behavior, biology,
and genetics—all of which can have profound effects on health, including
cancer risk and outcomes. Also, certain groups in the United States experience
cancer disparities because they are more likely to encounter obstacles
in getting health care.
“Many people in minority populations are struggling financially and
lack access to quality health care and health insurance,” according
to Sarah Joseph, M.D., a gastrointestinal medical oncologist at
Miami Cancer Institute. “In addition, a large percentage have hourly jobs where it can
be a real challenge to take time off from work and get to and from health
screenings and doctors’ appointments.”
Another reason for cancer health disparities,
Dr. Joseph says, is that Blacks/African-Americans tend to have a higher degree of
comorbidities – other diseases they may be suffering from at the
same time – which can affect their cancer treatment and prognosis.
How can racial and ethnic disparities be improved?
Addressing racial disparities in cancer care – and healthcare in
general – requires looking at the root
causes, according to Dr. Joseph. “We need to expand health care
coverage, which entails providing cost-effective insurance, and also improve
access to healthcare providers,” she says. “We also need to
do more to educate the population on the signs and symptoms of cancer,
and the importance of regular cancer screenings and preventative care.”
Dr. Joseph also suggests decreasing access to cigarettes, providing more
outlets for a healthy lifestyle including diet and exercise, and making
vaccinations such as Gardasil, which can prevent cervical cancer in women,
more accessible. “Knowing your family history is also very important,
as it can help guide you towards screening,” Dr. Joseph adds.
What can
you do to prevent cancer?
Dr. McDonald at Lynn Cancer Institute offers some easy but important preventative
measures people can take against cancer:
- Early detection is key as it leads to better survival, so make sure you
have an annual exam with your physician. This should include a clinical
breast exam starting at age 25.
- Perform self-exams of your breasts every month. Many breast cancers are
discovered by women during a regular self-exam.
- Know your family history so you can intervene early either with genetic
testing or enhanced breast screening.
- Have a mammogram every year starting at age 40. (Dr. McDonald often suggests
a baseline mammogram at 35 years for all women.)
- Eat a healthy diet mixed with grains, vegetables, and fruits.
- Avoid tobacco use and limit alcohol intake.
- Exercise for at least 30 minutes daily and maintain a stable body weight.
Dr. McDonald stresses that these recommendations can benefit anyone, regardless
of what racial or ethnic group they belong to. “Following these
simple steps can not only help keep you healthy, it may also save your
life.”