Racial Gap in Treatment, Incidence of Cancer

April 28, 2011 -- Cancer incidence among minority populations is expected to double in the next 20 years, while only increasing about 31% among whites, according to a new report from government advisors.

The report, from the President’s Cancer Panel, says there are still striking inequities between racial groups in this country when it comes to cancer risk, incidence, treatment, and survival. In order to address those problems, the panel urges better data collection, more research, specialized training for doctors, and more help for patients who can’t speak English as they try to navigate an increasingly complex health care system.

“I think everybody is well aware of the changing demographics in America, as far as the aging of the population, which will increase the prevalence of cancer, and also what’s happening in terms of the ethnic shift in the populations in the United States,” says Margaret L. Kripke, PhD, a member of the President’s Cancer Panel.

“What we thought would be important is to see what impact that would have on cancer incidence and mortality in the United States,” she says. “And to our great surprise, it doesn’t seem to be well described and well characterized.”

There’s some information, but it’s piecemeal, Kripke says. Without a comprehensive and cohesive picture, “we may be missing some opportunities to do prevention that could be very important.”

Racial and Ethnic Differences in Cancer

Among areas of concern, the experts say, are striking differences in survival between white and black women who get breast cancer, even if they get the same kind of care.

Hispanic women appear to have different risk factors for breast cancer than white women, though the screening recommendations are the same for both groups.

African-American men are more likely to get prostate cancer than men of other ethnic groups, and they’re also more likely to die from it, though the reasons are not well understood.

And children who carry genes associated with Hispanic or Latino ancestry are more likely to relapse after a diagnosis of acute lymphoblastic leukemia, emerging evidence shows.

The report concludes that the reasons for these and other disparities are complex.

Some differences may have genetic underpinnings, for example, while others may be because certain groups have trouble accessing the health care system or getting culturally sensitive or appropriate help once they do.

Many disparities, the panel notes, probably have less to do with race than they do with poverty and education.

“I agree with the report that race/ethnicity is a poor proxy for the major things that should be looked at like socioeconomic status and the level of education and in the case of Hispanics and other immigrant populations, acculturation,” says Richard Warnecke, PhD, professor emeritus and co-director of the center for population health and health disparities at the Institute of Health Research and Policy at the University of Illinois College of Medicine in Chicago. “But they right now don’t collect that data. It’s very hard to get data on socioeconomic status.”