Disparity exists in diagnosis, death rates from common cancers


Cancer doesn’t play fair to begin with, and if you’re African American the risk of getting and/or dying from the disease is even greater.

While overall risk of both developing and dying from all types of cancer is the same for African Americans as white Americans, the most common types are particularly bad actors for black patients.

For example, prostate cancer is the most common cancer for men, but one in five African Americans are diagnosed with it, compared to one in six white men, and one in 22 blacks will die compared to one in 39 whites. This makes African American men the most likely group in the world to die from this very curable type of cancer.

For women, African Americans are both more likely to be diagnosed with and die from breast cancer then whites, with particularly stark difference in Tennessee. Here, 33 black women per 100,000 die from breast cancer compared to just shy of 22 per 100,000 for white women, making its death rate one of the highest in the country.

The differences were once much greater, and the five-year survival rate from cancer for African Americans has gone up from 27 percent in 1960-1963 to 60 percent in 2002-2008. However, that lags overall survival rates, with 69 percent of whites living five years or more beyond a cancer diagnosis.

The reasons why aren’t completely clear. Lack of adequate screening may be a problem. For instance, although approximately the same percentage of black and white women get mammograms, more African Americans are diagnosed with later stage cancer—indicating perhaps too long a lag time between tests or improper follow-up of suspicious results.

But biological differences could also account for higher mortality rates among blacks.

Take prostate cancer. In a recent study, scientists discovered that among a group of men considered to have low-risk prostate cancer, when the cancer was ultimately treated African American men were found to have “threefold higher rates of more advanced aggressive disease, which resulted in much poorer outcomes, compared to white men,’” according to lead researcher Edward Schaeffer, quoted in Prostate Cancer Discovery newsletter, published by Johns Hopkins.

In a follow-up study it was discovered that although biopsies for these men indicated their disease was low risk, later analysis of the tumors showed high-grade cancer in areas of the prostate not easily detected through testing.

“’This work suggests that there may be biologic differences in the prostates of African American men that drive these tumors to develop in a different location, and this will be a key area of our research in the future,’” said Debasish Sundi, a lead author in both studies.

Research indicates biological variances between black and white patients may be influential in breast cancer as well.

Whatever the factors, what’s most important is for African Americans to be educated and aware of their risk for cancer and its potential outcomes. The American Cancer Society recommends:

–       Annual mammograms for women over 40 at low risk and women 30 and older at high risk for breast cancer

–       HPV and Pap “co-testing” every five years for women 21- to 65-years-old

–       Colorectal screening for men and women 50 and older

–       Discuss prostate cancer screening with a physician by age 45 and age 40 for those with immediate family members who have been diagnosed at an early age

For more information on this topic, see the American Cancer Society report, Cancer Facts & Figures for African Americans, 2013 and Populations of Color in Tennessee: Final Health Status Report produced by the Tennessee Department of Health.