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/AfricanAmerican 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.”