Cancer isn't really an equal opportunity disease. It is the second-biggest killer of Americans (after heart disease), but your gender, race/ethnicity, socioeconomic level, and more have a big impact on whether you get cancer, when you develop it, and what your chance of survival is.
In this, the first in a series, TakePart takes a look at specific groups of people who bear an extraordinary burden when it comes to cancer: These are the Americans who are paying a very high price and who live with the real "costs" (financial, physical, mental and emotional) of the disease.
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STATISTIC: African-American men are more likely to have cancer, and they are about 20 percent more likely to die of it.
Everyone fears cancer, but perhaps no group should fear it more than African-American men. As a group, black men have higher rates of several common types of cancers and are also more likely to die from the disease compared to other racial and ethnic groups. The death rate for cancer in black men is 288.3 per 100,000 people compared to 221.9 for non-Hispanic white men.
Consider these facts:
• The death rate for prostate cancer in men is about 2.4 times higher than in white men. For reasons that are unclear, prostate cancer in black men is often a more aggressive disease, which leads to higher death rates.
• African-American men are 1.4 times more likely to have lung cancer (the leading cause of cancer deaths in men) and 1.5 times more likely to have prostate cancer compared to white men.
• African-American men are twice as likely to have stomach cancer as white men.
• African-American men had lower five-year cancer survival rates for lung, colon, and pancreatic cancer compared to white men.
In some cases, black men suffer more due to genetic differences. Recent studies from the National Cancer Institute's Cancer Genetic Markers of Susceptibility program found changes in DNA that are linked to the risk of developing cancer. Each difference in the DNA contributes to an increased, or decreased, risk of cancer, and nearly all of the differences linked to an increased risk for prostate cancer were found in most black men. Men with certain combinations of these variants had a stunning five-fold increased risk of developing the disease.
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But non-medical factors play a role in cancer incidence and death rates too. Studies show black men are less likely to get regular healthcare examinations and screening for prostate cancer, perhaps due to lack of health insurance coverage or access to healthcare services. "There are disparities in every aspect of the cancer care continuum," says Dr. David Wetter, a professor in the department of Health Disparities Research, Division of Cancer Prevention and Population Sciences, at the University of Texas MD Anderson Cancer Center, in Houston. "From primary prevention—like getting kids not to smoke—to prevention programs to screening to early detection to treatment to follow-up. Disparities are influenced to a huge extent by socioeconomics, but they are also influenced by overt racism."
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Members of some minority groups are less likely to be recommended for certain tests or treatments, for example, he says.
Information and new technology that can reduce new cases of cancer and deaths from the disease are also slower to reach some racial and ethnic groups. "Lung cancer is often caused by smoking," Wetter says. "African-American men used to have lower rates of lung cancer until they caught up to whites in smoking rates. Once we determined that smoking was bad for you—when the Surgeon General's report came out—we started to see smoking…rates go down in whites. It took longer for African-Americans to get the benefits of that information." Public health experts are now devising cancer prevention programs that target African-American men.
Why do you think black men in the U.S. bear such a huge burden when it comes to cancer? What can be done?
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Shari Roan is an award-winning health writer based in Southern California. She is the author of three books on health and science subjects.
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