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Cancer Health Disparities

(A U.S. National Cancer Institute Report released on April 21, 2002)

 

Cancer affects people of all racial and ethnic groups. An estimated 555,500 Americans are expected to die of the disease in 2002.

 

However, a close look at cancer rates for racial and ethnic groups reveals some significant differences. Such differences have been described as “health disparities.” A National Institutes of Health working group defined health disparities as “differences in the incidence, prevalence, mortality, and burden of cancer and related adverse health conditions that exist among specific population groups in the United States. These population groups may be characterized by gender, age, ethnicity, education, income, social class, disability, geographic location, sexual orientation.”

 

One important example of a health disparity is African-Americans’ higher overall cancer incidence and mortality (death) rates compared to other groups. Additionally, certain racial/ethnic groups experience higher rates for specific cancers than other groups.

 

Many of the differences in cancer incidence and mortality rates among racial and ethnic groups may be due to factors associated with social class rather than ethnicity. Socioeconomic status (SES) in particular appears to play a major role in the differences in cancer incidence and mortality rates, risk factors, and screening prevalence among racial and ethnic minorities. Moreover, studies have found that SES, more than race, predicts the likelihood of a group’s access to education, certain occupations, and health insurance, as well as income level and living conditions, all of which are associated with a person’s chance of developing and surviving cancer.

 

One purpose of this fact sheet is to give a brief overview of the currently available data on cancer health disparities among racial and ethnic groups. The rates are based on statistics from the National Cancer Institute (NCI) and the National Center for Health Statistics.* It should be noted that these agencies are concerned that the small size of some non-white population groups and the methods used to collect data have the potential to yield counts that are unrepresentative of the group as a whole. Work to overcome these problems is ongoing (see under Selected NCI Research Activities, SEER Program Expansion).

 

The fact sheet also summarizes some NCI research projects and initiatives designed to understand and eventually eliminate these disparities.

 

 

CANCER RATES

 

OVERALL INCIDENCE AND MORTALITY RATES

The following U.S. incidence and death rates are for all cancers combined.

·        Cancer Incidence Rates (Number of new cases each year).

 

Statistics are for 1992-1999, are adjusted to the 2000 US standard million population, and represent the number of new cases of invasive cancer per year per 100,000 of both sexes, males, and females, respectively.

 

 

Group	Both Sexes	Males	Females
African-American	526.6	703.6	404.8
White	480.4	568.2	424.4
Asian/Pacific Islander	348.6	408.9	306.5
Hispanic/Latino	329.6	393.1	290.5
Amer Ind/Alaska Nat	244.6	277.7	224.2

 

 

·        Cancer Death Rates (Number of deaths each year).

 

Statistics are for 1992-1999, are adjusted to the 2000 US standard million population, and represent the number of deaths per year per 100,000 of both sexes, males, and females, respectively.

 

 

Group	Both Sexes	Males	Females
African-American	267.3	369.0	204.5
White	205.1	258.1	171.2
Asian/Pacific Islander	128.6	160.6	104.4
Hispanic/Latino	129.2	163.7	105.7
Amer Ind/Alaska Nat	128.6	154.5	104.4

 

 

African-Americans

 

African-Americans have the highest incidence and death rates overall, as well as the highest rates for certain cancers.

 

·        African-American Females—Highest incidence rates for certain cancers.

 

Among females, African-Americans have the highest incidence rates of certain cancers, such as colon and rectal cancer and lung and bronchus cancer. Rates are also available for whites, Asian/Pacific Islanders, Hispanics/Latinas, and American Indian/Alaska Natives for these and other cancer sites. Statistics are for 1992-1999, are adjusted to the 2000 US standard million population, and represent the number of new cases of invasive cancer per year per 100,000 females.

 

 

Group	Colon and Rectum—Incidence	Lung and Bronchus --Incidence
African-American	55.8	53.2
White	46.1	51.1
Asian/Pacific Islander	39.5	28.5
Hispanic/Latina	29.7	22.8
Amer Ind/Alaska Nat	30.8	23.3

 

·        African-American Females—Highest death rates for breast cancer.

African-American females experience higher death rates from breast cancer than any other racial or ethnic group, even though whites experience higher incidence rates. Statistics are for 1992-1999, are adjusted to the 2000 US standard million population, and represent the number of deaths or new cases of invasive cancer, respectively, per year per 100,000 females.

 

 

Group	Female Breast—Death	Female Breast--Incidence
African-American	37.3	120.7
White	29.3	137.0
Amer Ind/Alaska Nat	14.8	59.4
Hispanic/Latina	17.5	82.6
Asian/Pacific Islander	13.1	93.4

 

 

·        African-American Males—Highest incidence rates for certain cancers.

 

Statistics are for 1992-1999, are adjusted to the 2000 US standard million population, and represent the number of new cases of invasive cancer per year per 100,000 males.

 

Group	Prostate-Incidence		Colon and Rectum-Incidence		Lung and Bronchus-- Incidence
African-American	275.3	70.7		124.1
White	172.9	64.4		82.9
Amer Ind/Alaska Nat	60.7	40.7		51.4
Hispanic/Latino	127.6	43.9		44.1
Asian/Pacific Islander	107.2	58.7		63.8

 

 

·        African-American Males—Highest death rates for certain cancers.

 

Statistics are for 1992-1999, are adjusted to the 2000 US standard million population, and represent the number of deaths per year per 100,000 males.

 

 

Group	Lung and Bronchus--Death	Prostate--Death	Colon and Rectum --Death
African-American	113.0	75.1	34.8
White	81.7	32.9	26.7
Amer Ind/Alaska Nat	49.3	18.8	14.6
Hispanic/Latino	38.2	22.6	16.6
Asian/Pacific Islander	42.3	15.1	16.5

 

 

HispanicS/Latinos

 

While Hispanics/Latinos have lower incidence and death rates overall compared with those of African-Americans and whites, they do experience higher rates for certain cancers.

 

·        Hispanic/Latina Females—Highest incidence rates for cervical cancer.

 

Statistics are for 1992-1999, are adjusted to the 2000 US standard million population, and represent the number of new cases of invasive cancer per year per 100,000 females.

 

 

Group	Cervix Uteri—Incidence
Hispanic/Latina	17.5
African-American	13.3
Asian/Pacific Islander	11.7
White	9.6
Amer Ind/Alaska Nat	7.7

 

 

·        Hispanic/Latina Females—Cervical cancer death rates.

 

Despite high incidence rates, Hispanic/Latina females have the second highest death rate for cervical cancer; African-American females have the highest. Statistics are for 1992-1999, are adjusted to the 2000 US standard million population, and represent the number of deaths per year per 100,000 females.

 

 

Group	Cervix Uteri--Death
African-American	6.7
Hispanic/Latina	3.8
Amer Ind/Alaska Nat	3.3
Asian/Pacific Islander	3.1
White	2.8

 

 

·        Hispanic/Latino Males—Incidence rates for prostate cancer.

 

Hispanic/Latino males have the third highest incidence rate for prostate cancer after African-Americans and whites. Statistics are for 1992-1999, are adjusted to the 2000 US standard million population, and represent the number of new cases of invasive cancer per year per 100,000 males.

 

 

Group	Prostate--Incidence
African-American	275.3
White	172.9
Hispanic/Latino	127.6
Asian Pacific Islander	107.2
Amer Ind/Alaska Nat	60.7

 

 

·        Hispanic/Latino Males—Death rates for prostate cancer.

Death rates for Hispanic/Latino males reveal that they have the third highest death rates from prostate and colon and rectal cancer, after African-Americans and whites. Statistics are for 1992-1999, are adjusted to the 2000 US standard million population, and represent the number of deaths per year per 100,000 males.

 

 

Group	Prostate--Death	Colon and Rectum--Death
African-American	75.1	34.8
White	32.9	26.7
Hispanic/Latino	22.6	16.6
Amer Ind/Alaska Nat	18.8	14.6
Asian/Pacific Islander	15.1	16.5

 ASIAN/PACIFIC ISLANDERS

While Asian/Pacific Islanders experience lower rates overall compared with other minority groups, they do experience higher death and incidence rates for certain cancers.

 

Asian/Pacific Islanders are not a homogenous population and contain subgroups that have different cancer rates.

 

·        Highes