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Cancer death rates declining faster among blacks than whites, but disparities persist

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February 20, 2019

Len Lichtenfeld, MD
Len Lichtenfeld

Overall cancer death rates are dropping faster among black Americans than white Americans, according to a report published in CA: A Cancer Journal for Clinicians.

Blacks still carry a disproportionate share of the cancer burden in the United States, with the highest death rates of any racial or ethnic group for most cancers. However, the disparity between blacks and whites has narrowed significantly over the past several decades and has been almost eliminated among men younger than 50 years and women older than 70 years.

However, socioeconomic barriers to quality health care still appear to stand in the way of fully closing the gap.

“Seeing the substantial progress made over the past several decades in reducing black-white disparities in cancer mortality is incredibly gratifying,” Len Lichtenfeld, MD, interim chief medical officer for American Cancer Society, said in a press release. “This progress 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. To continue this progress, we need to expand access to high-quality cancer prevention, early detection and treatment for all Americans.”

American Cancer Society provides estimates of new cancer cases and deaths among black Americans every 3 years to track progress against inequalities. Investigators gathered data on cancer incidence, survival, screening and risk factors from the NCI, North American Association of Central Center Registries and National Center for Health Statistics.

They projected about 202,260 new cases of cancer and 73,030 cancer-related deaths in 2019 among black Americans. The most common cancers included prostate (30% of estimated new cases among black men in 2019) and breast cancer (32% of estimated new cases among black women in 2019).

Projections also show lung cancer as the leading cause of cancer death among black men (25% of deaths) and black women (20% of deaths). Sharp decreases in lung cancer among black men from 2006 to 2015 contributed to a faster decline in the overall cancer incidence rate for black men (2.4% per year) than white men (1.7% per year).

Overall cancer incidence in black women remained flat during this period — with increases in rates of breast, uterine corpus and pancreatic cancer balanced by decreases in and lung and colorectum cancer — but increased slightly in white women.

Cancer death rates declined faster among black men (2.6%) than white men (1.5%) and black women (1.5%) than white women (1.3%) during the period.

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From 1990 to 2016, the risk for overall cancer death in black Americans compared with white Americans dropped from 47% to 19% among men and 19% to 13% among women.

The 25 years of continuous declines in the cancer death rate for black Americans translated to approximately 462,000 fewer cancer deaths overall.

Researchers noted that the estimates for 2019 are model-based, 3-year-ahead and 4-year-ahead projections that should be taken with caution.

“Although African-American/black individuals continue to bear a disproportionate share of the cancer burden, substantial progress has been made over the past several decades to reduce this disparity,” Carol E. DeSantis, MPH, director of breast and gynecological cancer surveillance at American Cancer Society, and colleagues wrote. “Continued progress toward equitable cancer outcomes will require expanding access to high-quality cancer prevention, early detection, and treatment for all Americans.” – by John DeRosier

Disclosures: All authors are employed by American Cancer Society and report no relevant financial disclosures.

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