The United States has made strides recently in improving the outlook for people with cancer. Deaths from the disease have dropped for two years in a row. But a new American Cancer Society report shows that progress has been slower among African Americans than people of other races in this country.

Death rates from cancer have been declining among both African American men and women, according to Cancer Facts & Figures for African Americans 2007-2008. Yet the cancer death rate is still 35% higher for African American men compared to white men and 18% higher in African American women compared to white women. In fact, African Americans have the highest death rate and shortest survival rate of any other racial or ethnic group for most cancers, the report says.

The reasons for these differences aren't completely understood, but economic and social gaps are believed to play a large role. Nearly a quarter of African Americans in the US live in poverty, and 20% are uninsured, the report says. People who are poor and uninsured are more likely to have their cancers found later, when they're harder to treat, and are more likely to receive substandard care.

"Access to insurance and healthcare as well as health education play an important role in one's health, but a lot of African Americans do not have access to these tools," said Durado Brooks, MD, director of prostate and colorectal cancers at ACS. "This report makes clear there is a need for more focus on improving socioeconomic factors and providing educational opportunities that can help further lessen cancer's unequal burden on African Americans."

The report estimates there will be 152,900 new cases of cancer among African Americans in 2007, and 62,780 cancer deaths.

As in the population at large, lung cancer is the leading cause of cancer death in African American men and women, though it is only the second most common cancer among both sexes. In 2007, 21,550 lung cancer cases and 16,700 deaths from lung cancer are expected among African Americans.

This cancer is more common among African American men than white men, partly because of differences in smoking. More African American men smoke, and more of them smoke mentholated cigarettes, which may be more harmful than regular cigarettes. Still, lung cancer rates have been decreasing among African American men since 1984, though rates continue to rise among African American women.

Colorectal cancer is the third most common cancer and the third leading cause of cancer death in both African American men and women. Rates of this cancer are higher among African Americans than among whites, as are deaths.

Around 16,440 new cases and 7,070 deaths from colorectal cancer are expected in African Americans in 2007. African Americans have lower 5-year survival rates for this disease than whites, in part because it is typically detected at a later, more advanced stage in African Americans.

Death rates from breast cancer, the most common cancer among African American women, are much higher than for white women, even though fewer African American women get the disease.

The report lists several reasons for this gap. Differences in access to and use of early detection screening tests are one reason. Studies have further shown that African American women don't get treated for breast cancer as promptly and don't always receive the highest quality care. Biology also plays a role; aggressive tumors are more common in African American women than white women.

Overall, the report estimate 19,010 new breast cancer cases and 5,830 breast cancer deaths in 2007 among African American women.

Around 1,910 new cases of cervical cancer are expected in African American women in 2007. The incidence of this cancer has been declining, but it is still 30% higher in African American women compared to white women.

The death rate is also higher. African American women are twice as likely to die from cervical cancer as white women. Some 720 deaths from cervical cancer are expected in 2007.

Among African American men, prostate cancer is the most common cancer and the second leading cause of cancer death. The death rate for this disease is more twice as high among African Americans as whites. The incidence rate is also higher. Death rates have been declining in African American men, but not as quickly as they have dropped in white men. Screening rates are also lower compared to whites.

About 30,870 new cases of prostate cancer and 4,240 deaths are expected to occur among African American men in 2007.

The report was released to coincide with Black History Month, observed every February.