Gap in Cancer Death Rates Between Blacks and Whites Narrows

Cancer death rates have historically been higher for African Americans than for whites, but that gap has been narrowing over the past few decades. The overall cancer death rate is dropping faster in Blacks than in whites, mostly in 3 cancer types: lung, colorectal, and prostate.

“Cancer Statistics for African Americans, 2019,” published in the American Cancer Society’s journal CA: A Cancer Journal for Clinicians, along with its companion piece Cancer Facts & Figures for African Americans 2019-2021, provides numbers on new cancer cases, deaths, survival, screening test use, and risk factors for African Americans.

• From 2006 to 2015, the overall cancer death rate declined faster among Black men and women than white men and women in the US. (2.6% vs. 1.6% per year for men and 1.5% vs. 1.3% per year for women). Continuous declines for the past 25 years have meant more than 462,000 fewer cancer deaths.
• Among men, the overall cancer death rate was 47% higher for Blacks than for whites in 1990 versus 19% higher in 2016.
• Among women, the disparity decreased from 19% to 13% over the same period, with the gap nearly eliminated for some age groups.

“Seeing the substantial progress made over the past several decades in reducing Black-white disparities in cancer mortality is incredibly gratifying,” said Len Lichtenfeld, MD, interim chief medical officer for the American Cancer Society, in a statement. “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.”

Racial gaps remain despite progress

African Americans in the US still have the highest death rate and lowest survival rate of any racial or ethnic group for most cancers. About 202,260 new cancer cases and 73,030 cancer deaths are expected among Blacks in the US in 2019.

Much of the difference is because of lower socioeconomic status and less access to medical care.  For example, the study authors note that in 2017, the proportion of Blacks living below the federal poverty level (21%) was more than double that of whites (9%), and 22% of Blacks had completed 4 years of college compared with 36% of whites. People with lower socioeconomic status face more barriers to high-quality health care, including lack of insurance.

About 98,020 cancer cases in Black men and 104,240 cases in Black women are expected to be newly diagnosed in 2019. Prostate cancer is the most commonly diagnosed cancer in Black men, and breast cancer is the most commonly diagnosed in Black women. Each makes up nearly one-third of cancers diagnosed in each sex. Lung and colorectal cancers are the second and third most commonly diagnosed cancers in both Black men and women. Together, the 4 most common cancers (breast, prostate, colorectal, and lung) account for more than one-half (54%) of all cancer cases among Blacks.

Gap differs among age groups

The progress is even more striking in some age groups.

• Among men ages 40 - 49, the cancer death rate during 1990-1991 was 102% higher in Blacks than in whites. But it was only 17% higher during 2015-2016.
• Among women ages 40 - 49, the gap narrowed from 44% in 1990-1991 to 30% in 2015-2016.
• Among Black women ages 80 to 89, the death rate was 8% higher than among white women during 2002-2003, but 3% lower during 2015-2016.

Additional findings:

• In Black men, rates of new cancer cases overall from 2006 to 2015 decreased by 2.4% per year compared with 1.7% per year for white men.
• In Black women, rates of new cancer cases overall from 2006 to 2015 remained unchanged compared with a slight increase in white women. This is because rates for breast, endometrial, and pancreatic cancer went up while rates for lung and colorectal cancer went down.
  

Closing the Gap

The American Cancer Society is committed to reducing cancer disparities.

• Since 2011, we have awarded more than 600 CHANGE grants,  which provided more than 915,000 cancer screenings in underserved communities at low or no cost.
• Our website, cancer.org, offers reliable and accurate information and news, including current information on treatments and side effects for every major cancer type, and programs and services nearby.
• Many of our programs and services have been developed to reach diverse audiences and provide greater access to care. They include rides to treatment, a place to stay during treatment, and help navigating the health care system.
• Our nonprofit, nonpartisan advocacy affiliate, American Cancer Society Cancer Action Network (ACS CAN), works at the state and federal levels to influence policies that will improve access to health care for everyone with cancer.
• Through our helpline, available 24/7, trained staff connect people to answers about a cancer diagnosis, health insurance assistance, American Cancer Society programs and services, and referrals to other services.