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Non-metropolitan areas, people of lower socioeconomic status, Black and American Indian/Alaska Native People carry highest cancer burden

American Cancer Society’s Cancer Disparities Report shows cancer disparities by socioeconomic status within each race are larger than disparities by race.

In a new, biennial report on the status of cancer disparities in the United States led by researchers at ACS, mortality from all cancers and leading causes of cancer death are substantially higher in non-metropolitan areas than in large metropolitan areas and in individuals with limited education (a proxy for lower socioeconomic status). The report also shows Black and American Indian/Alaska Native (AIAN) people continue to bear a disproportionately higher burden of cancer deaths, overall and from major cancers. The disparities in overall cancer mortality by education level within each race were considerably larger than the Black-White disparities, underscoring the major role of poverty in racial disparity. The researchers also found substantial disparities in social determinants of health, exposure to major modifiable cancer risk factors, and cancer screening, stage at diagnosis, and survival by metropolitan status and race. The findings are published in CA: A Cancer Journal for Clinicians.

“Our research suggests a major role for socioeconomic disparities in racial disparities in cancer mortality,” said Dr. Farhad Islami, senior scientific director, cancer disparity research at the American Cancer Society and lead author of the report. “It also shows substantial disparities in cancer occurrence and outcomes by geographic location, especially in younger ages.”

In 2021, the ACS published its first biennial report on the status of cancer disparities in the U.S. In this second report, the authors provide updated data on racial, ethnic, socioeconomic (educational attainment as a marker), and geographic (metropolitan status) disparities in cancer occurrence and outcomes and contributing factors to these disparities in the country. Researchers also review programs that have reduced cancer disparities and provide policy recommendations to further mitigate these inequalities.

“Many of the observed racial, socioeconomic, and geographic disparities in cancer mortality align with disparities in exposure to risk factors and access to cancer prevention, early detection, and treatment, which are largely rooted in fundamental inequities in social determinants of health,” added Dr. Ahmedin Jemal, senior vice president, surveillance and health equity science at the American Cancer Society and senior author of the research. “Overcoming these disparities will require equitable policies at all levels of government and broad interdisciplinary engagement to address fundamental inequities in social determinants of health. In the meantime, broad and equitable implementation of evidence-based interventions such as comprehensive tobacco control programs in each state can further mitigate cancer disparities in the U.S.”

“All people should have equitable access to quality, affordable health care,” said Lisa A. Lacasse, president of the American Cancer Society Cancer Action Network (ACS CAN), ACS’ advocacy affiliate. “This report underscores the need for lawmakers to support policies that help improve access to prevention, early detection and treatment services, such as increasing federal and state funding for the National Breast and Cervical Cancer Early Detection Programexpanding Medicaid in the 10 states that have not done so, and passing the federal Prostate-Specific Antigen Screening for High-Risk Insured Men Act. Doing so will help reduce the unequal burden of cancer and save more lives by identifying diagnoses at earlier stages when less invasive and less costly treatment options are available to patients.”

Other ACS authors include Dr. Jordan Baeker BispoDr. Hyunjung LeeDr. Daniel WieseDr. Robin YabroffDr. Priti BandiDr. Alpa PatelDr. Elvan DanielsDr. Arif KamalDr. Carmen Guerra, and Dr. William Dahut.

The report also was included in the OncoAlert newsletter on Nov. 16.


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