Race gap narrows for some cancers in African-Americans; continues to increase for others

While the overall death rate for cancer continues to drop among African Americans, the group continues to have higher death rates and shorter survival of any racial and ethnic group in the U.S. for most cancers. The findings come from Cancer Facts & Figures for African Americans 2011-2012, the latest edition of a report produced every two years by the American Cancer Society.

The higher overall cancer death rate among African Americans is due largely to higher mortality rates from breast and colorectal cancers in women and higher mortality rates from prostate, lung, and colorectal cancers in men. In recent years, death rates for lung and other smoking-related cancers and for prostate cancer have decreased faster in African American men than white men, leading to a narrowing of the gap in overall cancer death rates. Notably, lung cancer death rates for young African Americans and whites have converged in both men and women. In contrast, the racial disparity has continued to increase in recent years for colorectal cancer in both men and women and for breast cancer in women, cancers for which progress has been made through screening and improvements in treatment.

"While the factors behind these racial disparities are multifaceted, there is little doubt socioeconomic status plays a critical role," said Otis W. Brawley, M.D., American Cancer Society chief medical officer. "African Americans are disproportionately represented in lower socioeconomic groups. For most cancers, the lower the socioeconomic status, the higher the risk. It's important to note as well that the factors associated with socioeconomic status contribute to substantial differences in cancer incidence and mortality within racial and ethnic groups as well. People with lower socioeconomic status have higher cancer death rates, regardless of demographic factors such as race/ethnicity."

Highlights from the report include:

• About 168,900 new cancer cases and 65,540 cancer deaths are expected among African Americans in 2011.
  
• The most commonly diagnosed cancers among African American men are prostate (40% of all cancers), lung (15%), and colon and rectum (9%). Among African American women, the most common cancers are breast (34% of all cancers), lung (13%), and colon and rectum (11%).
  
• Lung cancer accounts for the largest number of cancer deaths among both men (29% of all cancer deaths) and women (22%), followed by prostate cancer in men (16%) and breast cancer in women (19%). For African American men and women, cancers of the colon and rectum and pancreas are expected to rank third and fourth, respectively, as the leading sites for cancer deaths.
  
• Although the overall racial disparity in cancer death rates has decreased, in 2007, the death rate for all cancers combined continued to be 32% higher in African American men and 16% higher in African American women than in white men and women, respectively.
  
• The use of colorectal screening tests among African Americans has continued to increase over the last two decades, but remains lower than whites (49% having reported a recent test compared to 56% in whites).
  
• About half (52%) of African American women aged 40 and older reported having a mammogram within the past year, slightly less than whites (54%).
  
• African American women and teen girls have the highest rates of obesity in the US. According to the most recent data (2007-2008) from the National Health and Nutrition Examination Survey, half of African American women and nearly 1 in 3 African American teen girls are obese. Obesity increases the risk of many cancers, including cancers of the breast (in postmenopausal women), colon, endometrium, kidney, and adenocarcinoma of the esophagus.
  
• According the National Health Interview Survey, in 2008 almost half of African American adults reported no leisure-time physical activity compared to about one in three whites.
  
• 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.