Disparities in Cancer Incidence Affecting Minority Groups
While anyone can develop cancer, that does not mean that cancer impacts everyone the same. Cancer disparities refers to the disparities, or differences, in the number of new cancer cases and the differences in treatment outcomes when comparing different populations. Often, these disparities have negative effects on racial and ethnic minority groups, sexual and gender minorities, adolescents and young adults, older adults, as well as those struggling financially. Effectively identifying disparities in cancer distribution and treatment across populations allows organizations to work efficiently to discover the best methods of reducing cancer risks across the entire population and to improve access to preventative care as well as treatment of cancer.
Disparities Impacting Racial and Ethnic Minorities
The population of the United States is demographically always evolving as the population is increasingly becoming more racially and ethnically diverse. At this point in time, individuals that identify with more than one race is the fastest growing demographic in the nation, followed by Asian Americans and Hispanic/Latino Americans. As the nation evolves to become ever more diverse, it is crucial that we recognize the disparities that impact these populations.
In general, health indicators like life expectancy and infant mortality have improved for the general population, members of racial and ethnic minority groups experience a disproportionate burden of preventable disease, disability, and death when compared to White individuals. Members of the Black, Native American, and Alaskan Native communities experience high rates of cancer health disparities among minority groups; these populations suffer the greatest rates of cancer incidence as well as the lowest survival rates.
Examples of Disparities
The National Cancer Institute is continually gathering statistics through their surveillance, epidemiology, and end results program. Their research includes information regarding specific disparities that can be seen regarding cancer incidence and mortality disparities among groups. To name a few of their findings:
- Blacks/African Americans face the highest death rates than all other racial and ethnic groups for most, although not all, cancer types.
- Black/African American women are more likely than White women to die from breast cancer, despite incidence rates being similar.
- Incidence rates of colorectal, lung, and cervical cancer are higher in rural Appalachia than urban areas in the region.
- Black/African American men are twice as likely as White men to die from prostate cancer; they also have the highest prostate cancer mortality among all population groups in the US
- Hispanic/Latino and Black/African American women have higher rates of cervical cancer than women of all other racial groups. Black/African American women suffer the highest mortality rate.
- Native Americans and Alaskan Native have higher death rates from kidney cancer than any other racial or ethnic group.
Causes of Disparities
The cancer disparities impacting these groups reflect the influence of numerous factors, including social determinants of health, behavior, genetics, and biology. Each of these factors can have a profound impact on health, which includes cancer risk and outcomes.
There are certain obstacles that members of these minority groups may face when attempting to receive healthcare. These obstacles include, but are not limited to:
- Low Income
- No health insurance
- No transportation to a medical facility
- Low health literacy
- Residing in a rural area, which may mean long travel distances to receive healthcare
- No paid medical leave/low paid medical leave
Individuals that do not have reliable access to health care are more likely to be diagnosed with late-stage cancer, which may have been treated more effectively if diagnosed earlier. This is because these individuals are likely not completing their routine health screenings and medical visits, which will prolong a diagnosis.
Environmental conditions also play a role in cancer disparities. Members of communities that lack clean water or air are more likely to be exposed to carcinogens, or cancer-causing substances. The communities lacking these resources are going to be those of low socioeconomic groups.
Neighborhoods that lack access to affordable, healthy foods or safe facilities for exercise are more likely to have poor diets, poor physical activity, and are more likely to be obese. Each of these are a risk factor for cancer development.
The health impact of systemic racism and the stress that that has on the human body is also a potential cause of cancer disparity. Regardless of socioeconomic status, individuals of minority groups are more likely to face institutional racism and will be negatively impacted by that. Members of minority groups face stress and potentially developing a mistrust of medical providers, bias towards healthcare, and/or only expect the worst when it comes to cancer diagnoses.
Inherited factors are also important to consider. For example, evidence suggests that there are differences in genetics, tumor biology, and immune response of triple-negative breast, colorectal, and prostate cancers in African Americans when compared to other ethnic and racial groups. The slight genetic differences among racial and ethnic groups may therefore play a role in cancer incidence as well.
Numerous factors impact cancer disparities and addressing them is not always cut and dry. To take steps closer to achieving health equity, which is reached when these health disparities are eliminated, policy changes will need to be taken to overcome the systemic social, racial, and/or institutional inequalities that are embedded within the current state of society.
Further Reading