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Black patients have higher mortality in most cancers, and gaps persist at higher incomes

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The American Cancer Society’s new annual report shows a significant gap in outcomes among white and Black patients. The report notes disparities in diagnosis and treatment.

Black patients continue to fare worse when it comes to cancer.

Image credit: ©9nong - stock.adobe.com

Black patients have higher mortality rates than white patients in most cancers, and those disparities persist even among Black patients with higher incomes. (Image credit: ©9nong - stock.adobe.com)

The American Cancer Society’s latest annual report repeatedly notes the continued disparities among Black patients in a host of cancers. The findings were published Wednesday in CA: A Cancer Journal for Clinicians,

“Mortality rates are two-fold higher for prostate, stomach and uterine corpus cancers in Black people,” researchers wrote.

Black patients also have lower survival rates for most cancers, they wrote. “After adjusting for stage, sex, and age, the risk of cancer death is 33% higher in Black people,” the study states.

Even Black patients with higher incomes continue to fare worse than white patients, researchers wrote.

The five-year cancer survival rate among Black patients with high socioeconomic status is 67%, compared to 72% for white patients with similarly high incomes.

Among childhood cancers, Black children are 24% more likely to be diagnosed with later stage cancer than white children, regardless of their insurance, the study found.

Uterine corpus cancer has one of the widest disparities in the mortality rate among Black and white patients. It is also one of the two cancers with the fastest increases in mortality (along with HPV-associated cancer).

The five-year survival rate for Black women with uterine corpus cancer is just 63%, while the survival rate for white patients is 84%, according to the report.

Black patients are more likely to be diagnosed with uterine corpus cancers at later stages, a factor driving the higher mortality rate. While 72% of white women are diagnosed with earlier, localized-stage cancers, only 56% of Black women are diagnosed at that earlier stage.

Researchers also pointed to gaps in the quality of care. Citing research of Medicaid beneficiaries, even though Black women had seen providers more often before their diagnosis of uterine corpus cancer, they “were one half as likely to receive guideline-concordant diagnostic procedures compared with White women,” the report stated.

Black women were also less likely than white women to receive appropriate treatment for uterine corpus cancer, also contributing to their higher mortality rate.

Among patients with breast cancer, Black patients continue to fare worse. The mortality rate for Black women with breast cancer is 41% higher than white patients. And that’s despite the fact that there’s a 4% lower incidence of breast cancer in Black women. The mortality disparity has remained consistent since the mid-2000s, researchers wrote.

Again, researchers point to less aggressive or attentive care for Black patients.

“Black women are also less likely to receive a provider referral for mammography and timely follow-up after an abnormal screening test,” the researchers wrote.

Other cancers with significant gaps in the mortality rate between Black and white patients are melanoma (23%), oral cavity and pharynx (15%), and urinary bladder (14%). Disparities in these cancers reflect the fact that Black patients are typically diagnosed at later stages of the disease, but Black patients typically have lower survival rates regardless of when they are diagnosed, researchers note.

While disparities persist, researchers note that progress is being made. The disparity in mortality among Black and white patients has dropped from a high of 33% in 1993 to 13% during 2016-20, the study finds. Researchers attribute the gap narrowing due to declines in smoking-related cancers in Black Americans.

The authors add that investing more in cancer prevention and reducing cancer disparities among Black patients, and among American Indian and Alaska Native patients, are critical steps in making progress in reducing cancer deaths.

Read more: Sustained commitment needed to brighten prostate cancer picture for Black men


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