Despite Gains, Black Americans Still Have Highest Cancer Death Rate

THURSDAY, Feb. 14, 2019 — A new report from the American Cancer Society brings good news and bad news for black Americans.

The number of black lives lost to cancer is falling, the report finds, and at a faster rate than observed among whites. That’s helping to close a decades-long “race gap” in cancer deaths between blacks and whites.

“Seeing the substantial progress made over the past several decades in reducing black-white disparities in cancer mortality is incredibly gratifying,” said Dr. Len Lichtenfeld, interim chief medical officer at the ACS.

However, even with that improvement, blacks still have the highest cancer death rate of any racial/ethnic group in the United States. That’s true for most cancer types, the report found.

In 2019, about 202,260 new cancer cases and 73,030 cancer deaths are expected to occur among black Americans.

The authors of the new report tracked statistics from three major databases as far back as 1990. In that year, black men had a 47 percent higher risk of dying of cancer compared to white men, and black women had a 19 percent higher risk of such deaths compared to white women.

However, by 2016 those percentages had shrunk to 19 percent and 13 percent, respectively, the ACS found.

The improvement was even greater in men younger than 50 and women 70 and older. In these groups, the black-white disparity in cancer deaths has nearly been eliminated, the ACS team said.

The improvements are largely due to significant declines in three of the four most common cancers, the researchers said. They found that the black-white disparity in cancer deaths has narrowed for lung, prostate and colon cancers, and has stabilized since 2010 for breast cancer.

One physician who works with prostate cancer patients said he’s seen these changes firsthand.

“While we continue to observe higher-grade prostate cancer in African-American men, my anecdotal evidence suggests that we are seeing more screen-detected cancers, at early stages,” said Dr. Manish Vira. He helps direct urologic research at Northwell Health’s Arthur Smith Institute for Urology in Lake Success, N.Y.

Vira said there’s been an “increase in awareness” among all patient groups about the need to get screened early for prostate cancer. Early detection of cancer typically brings a better chance of survival.

“There has been particular emphasis on improving screening compliance in high-risk populations,” Vira said.

The ACS report found an especially dramatic narrowing of black-white disparities in cancer deaths for certain age groups.

For example, among men ages 40 to 49, the cancer death rate was 102 percent higher in blacks than in whites in 1990-1991, but just 17 percent higher in 2015-2016.

Among women ages 40 to 49, the overall cancer death disparity between blacks and whites narrowed from 44 percent in 1990-1991 to 30 percent in 2015-2016.

The report also said that between 2006 and 2015, the overall cancer rate fell faster among black men (2.4 percent per year) than among white men (1.7 percent per year), largely due to larger declines in lung cancer among black men.

That last trend didn’t surprise lung specialist Dr. Len Horovitz, who pointed to recent advances in lung cancer screening.

“Particularly in the diagnosis of lung cancer, the use of low-dose lung CT scans will identify lung cancer in earlier stages, resulting in the possibility of cure or increased survival,” said Horovitz, who practices at Lenox Hill Hospital in New York City.

Lichtenfeld said the growing unpopularity of smoking has played a big role, too.

“Progress [against cancer] is driven in large part by drops in the lung cancer death rate driven by more rapid decreases in smoking over the past 40 years in blacks than in whites,” he said in an ACS news release. “To continue this progress, we need to expand access to high-quality cancer prevention, early detection, and treatment for all Americans.”

Lung cancer remains the leading cause of cancer death among both men (25 percent of deaths) and women (20 percent of deaths), followed by breast cancer in women (18 percent) and prostate cancer in men (15 percent). Colon cancer is expected to be the third-leading cause of cancer death for black men and women.

According to the ACS, cancer death rates peaked in black men and women in the early 1990s and have since declined, with a larger decrease in men, translating into more than 462,000 cancer deaths prevented over the past 25 years.

There was little change in the incidence of cancer among black women, but incidence increased slightly among white women. There were overall declines in lung and colon cancer, and increases in breast, endometrial and pancreatic cancer.

Prostate cancer is the most common cancer in black men, and breast cancer is the most common cancer in black women, each accounting for nearly one-third of cancers diagnosed in each sex, the report found.

Lung and colon cancers are the second and third most common cancers in both black men and women.

The report was published Feb. 13 in CA: A Cancer Journal for Clinicians.

More information

The U.S. National Cancer Institute has more on cancer disparities.

Posted: February 2019

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