The cancer death toll among black Americans remains the highest for all racial groups. That’s according to the American Cancer Society’s report: “Cancer Facts and Figures for African-Americans, 2011-2012.”
“Death rates among African-Americans for all cancers combined have been decreasing since the early 1990s,” the report stated. “Despite these declines, the death rates for all cancers combined continued to be substantially higher among African-Americans than whites during 1975-2007.”
Cancer mortality rates for black men are 32 percent higher than for white men, while the rate for black women with cancer is 16 percent higher than for white women, based on 2007 data, according to the report released earlier this month.
“The racial disparity between African-Americans and whites has decreased, but bare in mind, it is still wide,” said Alexis Thompson, associate director for Health Care Disparities and Special Population Initiatives at Northwestern University. “We’re encouraged by seeing the gap diminishing, but it is very clear that there’s still much more that needs to be done.”
For every 100,000 individuals, the cancer death rate among blacks is 216.3 compared to 177.1 among whites, based on the 2007 data in the current report. The picture has improved slightly since 2005 when the rate among blacks was 224.1 compared to 182.7 among whites.
Much of the racial disparity is due to breast and colorectal cancer in black women; and for black men-prostate, lung, bronchus and colorectal cancer. For breast cancer specifically, the survival rate for black women was 78 percent compared to 90 percent for white women from 1999-2006-and that’s despite improvements made in screening and treatment, the report notes.
The differences, the study shows, continue to result from disparities in access to insurance and medical care, and from conditions such as obesity.
Poverty, the data shows, is a leading cause of the racial disparity. That’s because poverty limits access to health care, such as screening for early detection when cancer is most treatable, preventive care and treatment services, according to the report.
About 25 percent of black Americans live below the poverty line, compared to 9 percent of whites. Meanwhile, roughly 19 percent of African-Americans are uninsured compared to 11 percent of whites, the report shows.
“We know, in fact, that the uninsured always do less well than the insured,” said Dr. Otis W. Brawley, American Cancer Society chief medical officer, citing a study he helped research from 2007.
Obesity also plays a role in racial disparities, according to the report. Half of African-American women, and nearly a third of black teenage girls are obese; and obesity is known to increase the risk of many cancers. Medical experts link obesity back to poverty and food choices made on tight budgets.
Some in the medical community attribute much of the disparities to unequal treatment from medical health professionals.
A 2002 study by the Institute of Medicine titled “Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care” showed that minorities in the United States are likely to receive lower-quality health care and less likely to receive appropriate medications.
The researchers found evidence that stereotyping and biases can lead to unequal treatment as well. Studies have shown delays in diagnosis and receipt of chemotherapy may be due to both patient and physician factors and that these need to be better addressed.
“Not all people are treated equally, and it may not even be at a conscious level,” said Dr. Karen E. Kim, director of the Office of Community Engagement and Cancer Disparities at the University of Chicago.
Brawley, however, believes greater awareness in the medical community has led to the slight decrease in racial disparities of cancer mortality rates.
“Doctors are correcting their behaviors,” he said. “They’re taking physical complaints more seriously.”