Cancer Disparities Research

Every 3 years, we publish the report Cancer Facts & Figures for African Americans and also write a scientific paper published in the American Cancer Society peer-reviewed journal, CA: A Cancer Journal for Clinicians.

These publications provide the most recent data on cancer incidence (newly diagnosed cases), mortality, survival, screening, and risk factors for African Americans.

Black people have the highest death rate and shortest survival of any racial/ethnic group for most cancers. This is due to disproportionate poverty and underlying systemic discrimination that reduce access to cancer screening, care that allows for early detection, and appropriate, high-quality treatment.  

For non-Hispanic Black men, compared to non-Hispanic White men:

• Incidence and death rates are higher for the most common cancers (prostate, lung, colorectal).
• The incidence rate of prostate cancer is 76% higher and the death rate is more than double.

For non-Hispanic Black women, compared to non-Hispanic White women:

• Death rates are 41% higher for breast cancer and almost double for uterine corpus (endometrial) cancers, despite similar incidence rates for both types.

For non-Hispanic Black people, compared with non-Hispanic White people:

• Kaposi sarcoma, myeloma, and stomach cancer incidence rates are almost 2 to 4 times higher.
• Diagnosis of cancer at a higher, or later, stage is more common.

For Spanish-speaking readers >>Datos y Estadísticas sobre el Cáncer entre los Hispanos/Latinos

Every 3 years, Kimberly Miller, MPH, a research scientist at the American Cancer Society (ACS), publishes the report Cancer Facts & Figures for Hispanics/Latinos (Spanish edition available Winter 2021) and also is the lead author for a scientific paper published in the ACS peer-reviewed journal, CA: A Cancer Journal for Clinicians. 

These publications provide updated cancer information on cancer occurrence and risk factors in the Hispanic/Latino population, as well as information about prevention, early detection, and treatment.

For Hispanic people, compared to non-Hispanic White people:

• Poverty rates in 2019 were more than double—16% compared to 7%. Socioeconomic disparities among Hispanic people are strongly linked to long-standing systemic racism, which prevents Hispanic people from receiving equitable access to high quality cancer care for prevention, early detection, and treatment.   
• The percentage of people without health insurance was nearly triple—26% compared to 9% among ages 18 to 64 years during 2017 to 2018. In fact, the Hispanic/Latino population has the highest percentage of people without health insurance of any major racial/ethnic group in the US.
• Incidence rates were lower for the four most common cancers (female breast, colorectal, lung, and prostate). This reflects the lower risk for these cancers among foreign-born people, who account for about a third of the Hispanic population. However, as population growth is now driven by births, not immigration, the cancer burden in Hispanic people is expected to increase.
• Incidence rates were higher for infection-related cancers—stomach, liver, and cervical—as well as for gallbladder cancer. Differences in cervical cancer are largely due to less access to HPV screening  and higher prevalence of HPV infection. 
• Disparities in 5-year survival rates were largest for melanoma. About 91% of Whites live at least 5 years after being diagnosed with melanoma, compared to only 78% of Hispanics.

Hispanic/Latino people born in the US may have cancer incidence rates more like non-Hispanic white people—or even higher. This is partly due to US acculturation—the adoption of attitudes, values, customs, beliefs, and behaviors of people in the US. When combined with socioeconomic disparities and systemic racism, acculturation leads to a higher burden of cancer risk factors, such as obesity and type 2 diabetes in US-born Hispanic people.

Certain Hispanic/Latino subpopulations have substantially varying cancer rates and risk factors. For example, lung cancer incidence rates are higher in Cuban men than in other Hispanic groups combined due to higher historical smoking rates.

Hispanic/Latino children and adolescents have higher rates of leukemia than all other racial and ethnic groups in the US. They have nearly double the rate in Black children, who experience the lowest rates.

Epidemiology researchers in the ACS Population Science department continually analyze data from the Cancer Prevention Study II (CPS-II) and CPS-3 to better understand factors that contribute to disparities.

Currently, we’re looking at:

• How living in a rural community affects the social determinants of healthy eating and active living and how together these factors contribute to the risk of developing or dying from cancer.
• How the COVID-19 pandemic has affected diet quality, physical activity, mental health, and cancer screening practices in different populations. Longer term, our epidemiologists will be able to understand the ongoing health effects related to COVID-19 in both the general population and in cancer survivors.
• The use of technology to help certain medically underserved populations get better access to evidence-based ways that help people adopt behaviors that help reduce the risk for developing cancer and improve their survival if they develop it, such as stopping smoking and increasing physical activity. 

We’re also adding new questions to the 2021 survey that will help us understand perceived discrimination and its impact on health by asking participants where, why, and when they have felt discrimination.