Cancer Strikes Blacks Harder than Whites

Incidence, death rates higher but improving

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HealthDay Reporter

FRIDAY, April 18, 2003 (HealthDayNews) -- Despite a substantial decrease in cancer among blacks over the last decade, this racial group still has consistently higher rates of almost all cancers than do whites, and their death rates are higher.

Statistics comparing incidences of colon, prostate, lung and breast cancers, the most common cancers for both whites and blacks, show the latter group's chances of developing certain types of cancer -- as well as dying from them -- are much higher than whites, says Dr. Mark Clanton, first national vice president of the national board of the American Cancer Society.

"Prostate cancer occurs in African-American men 60 percent more often than in white men, and they die from it 1.3 times more often, and African-American women have a 20 percent higher incidence rate of colon cancer and a 40 percent higher mortality rate than do white women of the same ages," Clanton says.

Further, while the incidence of lung cancer among black men has decreased 1.6 percent annually since 1995, their chances of contracting lung cancer are still 50 percent higher compared to the risk to white men.

These are among the sobering statistics released by the American Cancer Society in its latest report on the incidence of cancer among the 37 million Americans of black and Hispanic descent in the United States. The report is published in conjunction with National Minority Cancer Awareness Week, from April 20-26.

"Even without new advances in treatment and diagnosis of cancers, if we can engineer among African-Americans a similar reduced rate of cancer as that of whites, then tens of thousands of lives would be saved," Clanton says.

Dr. Harry Harper, an oncologist at the Hackensack University Hospital Medical Center, says oncologists are very aware of this discrepancy in cancer incidence.

"This information is out there among oncologists, but we haven't really taken a global approach to the problem," he says. "This report provides very helpful information so we can take the knowledge and start to use it to reach out to the communities that haven't shared in the benefits of cancer research and treatment."

The report is not all bad news. The overall incidence of cancer and mortality from the disease has dropped by 1.2 percent a year since 1993 for blacks. For black men, in fact, the drop in cancer rates was more than for white men during that same period, 2.1 percent a year versus 1.4 percent for white men. For black women, there has been a 0.4 percent drop annually since 1991, compared to a 0.8 percent drop for white women.

Also, five-year survival rates have also improved for blacks, more black women are getting regular mammograms -- 67 percent now compared to only 30 percent 10 years ago -- and black men, though not women, are smoking less.

But these improvements still leave a huge gap between cancer rates for blacks and whites, Clanton says, who points to economic disparities and lifestyle differences between the two groups.

While blacks make up only 12 percent of the population, they account for a third of the poor in this country, the report states.

Twelve percent of blacks have no health insurance, Clanton says, "which means they have considerably less access to screening and prevention advice."

Difficulty in geographical access to health care and less education about the importance of early screening for cancers are also factors, leading to later diagnoses of illness and thus lower rates of survival from cancers, Clanton says.

"Further, health-related behavior may predispose African-Americans to increased cancer risk, with smoking and exercise rates being the most important," Clanton says. "Exercise is emerging as a powerful way to reduce cancer, diabetes and heart disease."

While smoking rates between the two ethnic groups are not too dissimilar, black men and women have lower rates of exercise than do whites -- 48 percent of whites report engaging in regular, sustained exercise compared to 39 percent of blacks.

In addition, blacks are heavier. In 2000, 77 percent of black women were overweight, a jump from 59 percent in 1962. They also have a higher rate of obesity than do whites -- 30 percent versus 20 percent, according to the U.S. Centers for Disease Control and Prevention.

Obesity is associated with an increased risk for diabetes, heart disease and several types of cancer including those of the breast, colon, uterus and esophagus.

Clanton says that focus on disparities in cancer incidences between racial and ethnic groups is beginning to get the attention it deserves.

"The National Institutes of Health is creating a major focus on studying and trying to understand these disparities," he says. "We have to equalize the progress and improve the progress for the whole population."

More information

To read more about the discrepancies in cancer rates among ethnic groups, you can visit the American Cancer Society. Learn about cancer prevention from the National Cancer Institute.

SOURCES: Mark Clanton, M.D., first national vice president, national board, American Cancer Society, Dallas; Harry Harper, M.D., director, thoracic oncology, The Cancer Center, Hackensack University Hospital Medical Center, N.J.; Cancer Facts and Figures for African-Americans 2003-2004

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