While cancer mortality rates declined in the U.S. between 2000 and 2020, racial and ethnic disparities persisted for many cancers, a study published January 12 in JAMA Health Forum found.
The overall cancer mortality rate ratio between Black and white individuals decreased during the study period. However, the ratio increased for female breast cancer and male colorectal cancer, and disparities remained for prostate, male lung and bronchus, and female colorectal cancer, according to the study led by Anjali Gupta and Tomi Akinyemiju, PhD, from Duke University in Durham, NC.
“Our results underscore the importance of sustained, focused efforts to reduce cancer burden among Black patients across the continuum of cancer care,” Gupta and Akinyemiju wrote.
A report by the American Cancer Society suggests that cancer mortality has declined by one-third since 1991. This can be attributed to improvements in prevention, screening, diagnosis, and treatment. For breast cancer, this includes advancements in screening mammography technology and supplemental imaging such as ultrasound and MRI. For lung cancer, this includes low-dose CT and identifying who is eligible for screening.
However, the researchers noted that despite these advancements, racial and ethnic disparities persist. Previous studies show that non-Hispanic Black patients often face worse health outcomes than non-Hispanic white patients.
Gupta and Akinyemiju described cancer mortality disparities between Black and white individuals in the U.S. over the past two decades. They focused on data collected from the National Center for Health Statistics between 2000 and 2020.
The duo found that in 2000 the cancer mortality rate was 251.7 per 100,000-person population among Black individuals. For white individuals, this was 199.7 per 100,000. Both groups of patients experienced overall decreases in mortality over the next two decades, including 166.8 per 100,000 population for Black individuals and 149.3 per 100,000 for white individuals, respectively (p < 0.001 for trend).
“Between 2000 and 2020, declines in cancer mortality were observed for each cancer type for both groups,” the researchers wrote. “However, Black individuals consistently experienced higher mortality than white individuals for all cancers except female lung and bronchus.”
Additionally, the overall cancer mortality rate ratio between Black and white individuals decreased from 1.26 in 2000 to 1.12 in 2020. This included a corresponding decrease in absolute rate differences from 51.99 to 17.54 per 100,000 population.
However, the researchers also found that the rate ratio increased for female breast cancer from 1.31 to 1.37, as well as for male colorectal cancer from 1.44 to 1.45.
Additionally, they reported “considerable” disparities for other cancers. These included rate ratios for prostate cancer (2.49 to 2.08), male lung and bronchus cancer (1.32 to 1.13), and female colorectal cancer (1.4 to 1.26).
The study authors suggested that multilevel strategies could help improve health system relations with minority communities, improve access to healthcare, study racial and ethnic differences in tumor biology, and increase representation in enrollment for clinical trials.
The full study can be found here.
