Despite the fact that U.S. cancer death rates have decreased by 26% from 1991 to 2015, not all Americans have benefited equally from the advances in prevention, early detection, and treatments that have helped achieve these lower rates.
On Oct. 17, the American Cancer Society Cancer Action Network (ACS CAN) released a publication that illustrates health inequities across the cancer continuum and highlights policies ACS CAN is pursuing to address the disparate disease burden.
Cancer Disparities: A Chartbook illustrates the scope of cancer disparities that exist in the U.S., including cancer incidence, mortality, and survival; access to insurance coverage; screening and early detection; and behaviors that may increase cancer risk. It also details how ACS CAN is actively pursuing evidence-based public policies at the local, state, and federal levels that aim to reduce these disparities and improve health outcomes for all U.S. population groups.
Additionally, the chartbook highlights some of the greatest gaps and challenges, which will further guide ACS CAN in its public policy work. The publication includes more than 100 charts and maps detailing the extent of disparities across different populations. ACS CAN led the development of the chartbook, in collaboration with the American Cancer Society.
Public policy interventions are a critical strategy for substantially reducing, and ultimately eliminating, cancer disparities. ACS CAN will share this chartbook with state and federal policymakers to show the level of health inequities that continue to exist across the cancer continuum and to highlight public policies ACS CAN is advocating to address this problem.
The report is available online at fightcancer.org/disparitieschartbook. Hard copies are available for order in the RR Donelley catalog (listed as item number 872000) -- on Society Mart.
A quick overview
Research shows that racial/ethnic minorities and other medically underserved groups continue to have higher cancer rates and are less likely to be diagnosed early or receive optimal treatment compared to other groups. Individuals of lower socioeconomic status (SES) – income, education, occupation, etc. -- also suffer disproportionately from cancer and other disease burdens compared to individuals with higher SES, regardless of demographic factors such as race/ethnicity.
The underlying causes of disparities in cancer care are complex and include interrelated social, economic, cultural, environmental, and health system factors. Geographic location (e.g. rural versus urban areas or northern states versus southern states) also contributes to disparities in cancer care.
A few key facts
- Among females, non-Hispanic Whites have the highest overall cancer incidence rates, but non-Hispanic Blacks have the highest cancer death rates. Importantly, while Hispanic and Asian/Pacific Islander women have among the lowest incidence and mortality rates overall, they have among the highest rates of certain infection-related cancers, e.g., liver and stomach cancers.
- Among males, non-Hispanic Blacks have the highest cancer incidence and mortality rates overall, driven by high rates for the most common cancers (lung and bronchus, prostate, and colorectal). Similar to females, Hispanic, Asian/Pacific Islander, and American Indian/Alaska Native males generally have higher rates of cancers related to infections compared to non-Hispanic Whites.
- Since the mid-1970s, cancer incidence and mortality rates for all cancer types combined have been highest among Black males, although this disparity is narrowing in more recent years. Among females, although incidence rates are slightly higher in Whites, death rates remain highest in Blacks due to disparities in cancer survival. The excess risk of cancer death (or percentage by which cancer death rates in one group exceed another) in Blacks versus Whites dropped from 47 percent in 1990 to 19 percent in 2015 among males and from 21 percent in 1997 to 12 percent in 2015 among females.
- Reasons for differences in the incidence of childhood and adolescent cancers by race/ethnicity in the U.S. are not well understood. The cancer death rate is similar between non-Hispanic White, non-Hispanic Black, and Hispanic children, despite higher incidence rates in Whites. This is likely due to lower survival rates among Black and Hispanics compared to Whites.
TOP PHOTO: This graph illustrates obesity percentage among children and adolescents aged 2 to 19 years, 2015 to 2016. Overall, prevalence of obesity among youths age two to 19 years was highest among Hispanics (25.8%) and non-Hispanic Blacks (NHB) (22%) compared to 14.1 percent among non-Hispanic Whites and 11% among non-Hispanic Asians. Prevalence of obesity in Hispanics and NHB is about twice that of non-Hispanic Asians.