Racial Disparities Persist in Breast Cancer for Women and Colorectal Cancer in Men

Carol DeSantis, MPH

Carol DeSantis, MPH

A new analysis by the American Cancer Society (ACS) has found that racial disparities in mortality for breast cancer have gotten worse in women and persisted for colorectal cancer in men, although progress has been made in closing the mortality gap between blacks and whites for other cancers.

The ACS report collated cancer incidence data from the NCI, the CDC, and the North American Association of Central Cancer Registries; mortality data were drawn from the National Center for Health Statistics. Based on this information, the report predicts 189,910 new cases of cancer and 69,410 cancer deaths among blacks in 2016.

Death rates have dropped faster during the most recent time period in blacks than in whites for all cancers combined and for lung, prostate, and colorectal cancer (in women only). The overall cancer death rate in men was 47% higher in blacks than in whites in 1990, but reduced to 24% higher in 2012. Among women, the disparity decreased from 19% higher in 1991 to 14% in 2012.

On the other hand, the racial disparity has widened for breast cancer in women and remained constant for colorectal cancer in men, and this is likely due to inequalities in access to care, including screening and treatment, ACS noted in a statement.

Since 1990, breast cancer death rates dropped 23% in black women and 37% in white women. Breast cancer death rates in the most recent time period (2008-2012) are 42% higher in black women compared with white women, despite historically lower incidence rates.

From 2003 to 2012, colorectal cancer death rates declined faster in black women than white women (3.3% vs 2.9% per year) but declines were slower in black men than in white men (2.5% vs 3.0%), revealing that colorectal cancer rates in men have remained about 50% higher in blacks than in whites since 2005.

ACS reported that the 5-year relative survival rate is lower in blacks than in whites for every stage of diagnosis for most cancer sites, most of which can be attributed to barriers that limit access to timely, appropriate, and high-quality medical care, resulting in advanced stage at diagnosis, when treatment choices are more limited and often less effective.

In black men, incidence rates from 2003 to 2012 decreased by 2.0% per year for all cancers combined as well as for the top 3 cancer sites (prostate, lung, and colorectal). In black women, overall cancer incidence rates during this time remained unchanged, reflecting increasing trends in breast cancer countered by decreasing trends in lung and colorectal cancer rates.

Obesity increases cancer risk, and black women have the highest body mass index (BMI) of any sex-racial/ethnic group. During 2013-2014, nearly 60% of black women were obese compared with nearly 40% of white women.

“While some studies suggest that blacks who receive cancer treatment and medical care similar to that of whites experience similar outcomes, others report that racial disparities persist even after controlling for socioeconomic factors and access to care,” explained the report’s lead author Carol DeSantis, MPH, in a statement.

“The bottom line is, accelerating progress in eliminating racial disparities requires equitable access to services for prevention, early detection, and high-quality treatment.”

Reference

DeSantis CE, Sigel RL, Sauer AG, et al. Cancer statistics for African Americans, 2016: progress and opportunities in reducing racial disparities [published online ahead of print} CA Cancer J Clin.