Although the death rate from cancer in the United States has fallen steadily over the last two decades, racial/ethnic disparities in the rates of new cases and deaths persist, a report from the American Cancer Society finds.
According to the report, Cancer Statistics, 2018, in CA: A Cancer Journal for Clinicians, the overall age-adjusted cancer death rate in 2015 was 159 per 100,000 people, down 26 percent from its peak in 1991 — mostly due to reductions in smoking and improvements in early detection and treatment. The report also attributed the decrease in the overall mortality rate to lower mortality rates for lung, breast, prostate, and colorectal cancers.
At the same time, the report found persistent racial/ethnic disparities in mortality rates, with, for example, the cancer death rate for African Americans 14 percent higher in 2015 than the rate for white Americans. And while the overall black-white gap has narrowed from 33 percent in 1993, it was 31 percent in 2015 for individuals under the age of 65, compared with 7 percent for those 65 or older — a difference the report attributes largely to the universal healthcare access enjoyed by all seniors through Medicare. The report also found that African-American men had the highest rates of both cancer incidence (560.9 per 100,000) and mortality (246.1 per 100,000), with the mortality rate for African-America men from prostate cancer more than double that of all other groups. Similarly, while African-American women had a breast cancer incidence slightly lower than that of white women (125.5 per 100,000 vs. 128.7 per 100,000), their mortality rate was significantly higher (29.5 per 100,000 vs. 20.8 per 100,000). American Indians and Alaska Natives had the highest rates of kidney cancer incidence and mortality, with the highest rates found among Native American men in the Great Plains region.
The report further suggests that racial/ethnic disparities are influenced by socioeconomic status. In 2016, for example, 22 percent of African Americans lived below the poverty line, compared with 9 percent of white Americans, while lower-income people in general are more likely to smoke and/or be obese, due in part to limited access to healthy food and opportunities for physical activity. The report also found that 11 percent of African Americans were uninsured, compared with 6 percent of white Americans, and notes that research has shown that racial/ethnic minorities tend to receive lower-quality health care than white Americans.
"Black women get breast cancer, on average, five to seven years younger than white women, so our cancers are detected later, and when they're more advanced," Linda Goler Blount, president and CEO of the Black Women's Health Imperative, told Mother Jones. Younger African-American women also are more likely to have an aggressive form of breast cancer known as triple negative. The good news, Goler Blount said, is that more than 90 percent of black women are now insured thanks to the Affordable Care Act. "If this trend continues and black women continue to be insured, have access to preventive health care and quality treatment when diagnosed with cancer, we can expect the gap in deaths due to cancer compared with whites to decrease."