Cancer Death Rate for Black Americans Declines, Remains Higher Than That of Other Groups

By Jonathan Springston, Editor, Relias Media

The mortality rate attributed to cancer for Black people in the United States declined for 20 years, but the death rate remains higher for this group than for Americans from other ethnic and racial backgrounds.

Using data collected between 1999 and 2019 in the National Center for Health Statistics, researchers studied cancer death rates by sex, age, and cancer site among non-Hispanic Black patients age 20 years and older. Then, they compared this information to data from 2019 regarding cancer death rates among Black men and women vs. other racial and ethnic groups.

During the 20-year period, investigators noted more than 1.3 million Black men and women ages 20 years and older died from cancer. The mortality rate declined around 2% annually, slightly more among men than women. There were declines across most cancer types; the authors noted the stomach cancer mortality rate declined 3.4% for women, and the lung cancer rate declined 3.8% for men.

However, by 2019, researchers observed cancer mortality rates generally remained higher for Black men and women than for other groups. Death rates from liver cancer among older Black men and women and from uterine cancer among Black women actually increased over the study period. Deaths from prostate cancer for Black men was around five times higher than the rate among Pacific Islander or Asian men. The breast cancer mortality rate among Black women was about 2.5 times higher than that of Asian or Pacific Islander women.

“The factors associated with racial disparities in cancer death rates are primarily systemic and preventable. Black patients are more likely to experience poor patient-physician interactions, longer referral times, delays in treatment, greater medical mistrust, underuse of treatment, and healthcare system failure — all mutable factors,” the authors wrote. “In addition, Black individuals are more likely to reside in neighborhoods with poor accessibility to specialists, see physicians with fewer clinical resources, and live in communities with greater exposure to environmental toxins. Therefore, examining individual-level behavioral and biological factors is insufficient, and greater emphasis should be aimed at understanding the contribution of social inequities to higher cancer mortality rates among Black individuals.”

In a study led by the American Cancer Society, researchers found expanding Medicaid under the provisions of the Affordable Care Act was connected to a better two-year overall survival rate among patients who had just been diagnosed with cancer, especially among Americans living in rural areas and non-Hispanic Black patients.

"Evaluating the growing geographic disparities in cancer outcomes between people living in states that have not yet expanded Medicaid eligibility compared with those that have is critical, Karen Knudsen, MD, CEO of the American Cancer Society, said in a statement. “Cancer affects everyone, but not everyone equally. Studying and reducing disparities is an important part of our mission to improve the lives of cancer patients and their families.”

For more on this and related subjects, be sure to read the latest issues of Hospital Case Management and Medical Ethics Advisor.