Cancer mortality remains significantly elevated among African-Americans but if recent trends continue, cancer outcomes will disappear over time, according to a new analysis of "Health Equity" - defined by the US Department of Health and Human Services as the highest level of health for all people.
Between 2000 and 2010, overall mortality from cancer decreased faster among African American women and men than among Caucasians but they are still not equal. In 2010, for example, the total mortality rate from cancer was approximately 20 percent higher among African-Americans than among European-Americans. The causes of this disparity are complex, but risk factors for cancer that disproportionately affect African-Americans are assumed to be low education and income, and living in less healthy neighborhoods with reduced access to quality health care.
In the new work, Clinical Professor of Health Sciences Eileen O'Keefe and colleagues from Boston University College of Health&Rehabilitation Sciences: Sargent College and Slone Epidemiology Center, report major changes in cancer mortality in African-Americans and
during the first decade of the 21st century. To do so, the researchers analyzed representative nation-wide data from the "Surveillance, Epidemiology, and End Results" (SEER) program of the National Cancer Institute. They show that the disparity between African Americans and
in total cancer mortality decreased by 14.6% (from 16.4 to 14.0%) in women and 31.1% (from 40.2 to 27.7%) in men during this period.
This is due to a faster decrease in cancer mortality among African-Americans than among European-Americans. Should these trends continue, racial disparities in cancer outcomes would potentially be eliminated over time.
The progress in cancer outcomes for African-Americans seems to be partly driven by increased access to high-quality treatment and surgery, and partly by successful prevention strategies. The latter include helping people to quit smoking; more widespread screening and testing, which allows for earlier diagnosis and raises the probability that treatment will be successful; a decrease in the prescription of hormone replacement therapy (a risk factor for breast cancer) to women in the menopause; and an increase in the prescription of anti-inflammatory drugs that lower the risk of colorectal cancers.
Other results include:
- In 2010, the total number of cancer-related deaths per 1000 Americans per year was 1.7 among African-American women (down by 16% compared to 2000), 1.5 among European-American women (down by 14%), 2.6 among African-American men (down by 29%), and 2.1 among European-American men (down by 18%).
- The fastest decrease in cancer-related mortality was for prostate cancer among African-American men (down by 43% in 2010 compared to 2000), followed by prostate cancer among European-American men (down by 38%), and lung cancer among African-American men (down by 37%). The slowest decrease was for lung cancer among
women (down by 7%) and African-American women (down by 9%).
- In African-American and
women, the mortality rate due to lung, breast, and colorectal cancer declined between 2000-2010 by 7% to 36%, depending on cancer type and ethnicity.
- In African-American and
men, the mortality rate due to lung, prostate, and colorectal cancer declined between 2000-2010 by 26% to 43%, depending on cancer type and ethnicity.
- Lung cancer was the only type of cancer included in the present study for which African-Americans had a lower mortality rate than European-Americans, and this was only the case in women. The main cause is the historically lower prevalence of smoking among African American women compared to
Published in Frontiers in Public Health.