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Examples of Health Disparities

The following examples show the impact of cancer health disparities among racial and ethnic minorities and medically underserved communities. For more information, visit our Health Disparities Resources.

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African American

  • Death rates for all cancers combined for both men and women are highest among blacks.1
  • African American women who are diagnosed with breast cancer are less likely than White women to survive five years after diagnosis, the rate among African American women is 71%, compared to 86% among Whites.2
  • African American men have far higher death rates from prostate cancer than any other racial or ethnic group.  The death rate from prostate cancer is approximately 2.4 times higher in African American men than in white men.3
  • Incidence rates of colorectal cancer among African American men and women are higher than those among whites.3
  • Lung cancer is the leading cause of cancer death in African Americans.3

American Indians and Alaska Natives

  • American Indians and Alaska Natives continue to have the poorest survival from "all cancers combined" than any other racial group.4
  • Cancer data for American Indians/Alaska Natives from one region of the country cannot be used to generalize to Native people living in another part of the country. The types of cancer experienced within Native communities varies significantly by geographic region with some unusual patterns (e.g., colon and lung cancer among Alaska Natives; lung, cervical, breast, and prostate cancer among Northern Plains tribes; and stomach and gallbladder cancer among southwestern tribes).5
  • American Indian/Alaska Native women have the lowest cancer incidence rates and the third-highest cancer death rates.1
  • National Interview Survey data show that adult smoking among American Indians and Alaska Natives is the highest (40%) of the five racial and ethnic groups.6
  • Access to health care is a problem for American Indians and Alaska Natives, who are second only to Hispanics in lacking health insurance.7

Asian American and Pacific Islanders (AAPI)

  • Cancer has been the number one killer of Asian-American women since 1980.8
  • The average annual percent change in prostate cancer for AAPI men increased 1.4% between 1990 and 1995.  During the same period, the average annual percent change in prostate cancer for White American men decreased by 2.3%.9
  • AAPI women are the only U.S. population group that experienced an overall increase in cancer mortality for all cancers combined between 1990 and 1995.9
  • Between 1980 and 1993, the cancer death rate for AAPI women increased by 240%, and the rate for men increased by 290% -- the highest for all ethnic/racial groups.9
  • Korean men experience the highest rate of stomach cancer of all racial/ethnic groups, and a five-fold increased rate of stomach cancer over White American men.10
  • Cervical cancer is the number one cancer to occur in Vietnamese women.  Incidence rates in Vietnamese women are five times higher than the rate among White American women.10
  • Filipinos have the second poorest five-year survival rates for colon and rectal cancers of all U.S. ethnic groups (second to American Indians).11
  • Lung cancer rates among Southeast Asians are 18% higher than among White Americans.12
  • The incidence of liver cancer in Chinese, Filipino, Japanese, Korean, and Vietnamese populations are 1.7 to 11.3 times higher than rates among White Americans.10
  • All-site cancer mortality rates for Native Hawaiians, the largest of the Pacific Islander populations, are the second highest of all racial/ethnic groups (207.2 per 100,000 population), and closely rival those of African Americans (209.8 per 100,000 population).10
  • Native Hawaiian women have the highest incidence and mortality rates of endometrial cancers for all U.S. women.10
  • Once diagnosed with cancer, outcomes are poorer for Native Hawaiians as indicated by a 5-year relative survival rate that is 18% lower than Whites and 15% lower than U.S. (all races) for all cancer combined. With the exception of cancers of the stomach and ovary, Native Hawaiians had lower 5-year relative survival rates for 12 other cancer sites when compared to U.S. (all races).13

Hispanics/Latinos

  • Only 38% of Hispanic women age 40 and older have regular screening mammograms, a simple procedure that can detect breast cancer at its earliest stage, before clinical symptoms develop.14
  • While rates of stomach cancer have decreased dramatically over the decades among all race and ethnic groups, Latinos still have higher risks than Whites.15
  • Even though Hispanic women have lower rates of breast cancer (69.8 per 100,000) compared to non-Hispanic White women or Black women (111.8 and 95.4 respectively), breast cancer is the leading cause of cancer death among Hispanics.16
  • Hispanics experienced the highest invasive cervical cancer incidence rates (16.2 per 100,000) of any group other than Vietnamese, and twice the incidence rates of non-Hispanic White women (7.9 per 100,000).17
  • Low screening participation rates make Hispanic women more likely to be diagnosed at a more advanced stage of the disease when fewer treatment options are available, resulting in poorer outcomes and higher mortality.18
  • Cervical cancer risk is high among Latinas, with incidence rates that are double those of Whites. This risk differential has not appreciably improved over the last decades. Cervical cancer mortality is also markedly higher among Latinas.15
  • While Latinos represent about 12% of the population, they make up 25% of the Nation's uninsured. They are almost three times less likely to have a consistent source of medical care, so they rely more heavily on emergency room treatment. In fact, Latinos are 1.5 times more likely to use the hospital ER as a primary source of care compared with the general population.19

Footnotes
  1. U.S. Cancer Statistics Working Group. United States Cancer Statistics: 1999–2002 Incidence and Mortality Web-based Report. Atlanta: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention and National Cancer Institute; 2005.
  2. Ries LAG, Eisner MP, Kossary CL, Hankey BF, Miller BA, Edwards BK, editors. SEER cancer statistics review, 1973-1997. Bethesda, MD: National Cancer Institute; 2000. http://seer.cancer.gov/
    csr/1975_2003/results_merged/topic_race_ethnicity.pdf
  3. American Cancer Society. Cancer facts and figures for African Americans 2005-2006. Atlanta, GA: American Cancer Society; 2005.
  4. Institute of Medicine. Haynes MA, Smedley BD, editors. The unequal burden of cancer. An assessment of NIH research and programs for ethnic minorities and the medically underserved. Washington, D.C.: National Academy Press; 1999
  5. Cobb N, Paisano RE. Patterns of cancer mortality among Native Americans. Cancer 1998; 83(11):2377-83.
  6. Centers for Disease Control and Prevention.  Cigarette smoking among adults - United States 1998. MMWR Morb Mortal Wkly Rep 2000; 49(39):881-4. Available from: URL: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm4939a1.htm 
  7. U.S. Department of Health and Human Services. Indian Health Service. Regional differences in Indian health 1998-99. Rockville, MD: Department of Health and Human Services. Indian Health Service; 2000. Available from: URL: http://www.ihs.gov/PublicInfo/Publications/trends98/region98.asp
  8. National Center for Health Statistics, Health, United States, 1998 With Socioeconomic Status and Health Chartbook. Hyattsville, MD, 1998.
  9. National Center for Health Statistics.  Health, United States, 1995.  Hyattsville, MD: Public Health Service, 1996.
  10. Miller, BA, LN Kolonel, L Bernstein, JL Young Jr.  Racial/ethnic patterns of cancer in the United States 1988-1992.  Bethesda, MD: National Cancer Institute, 1996. [NIH Publication No. 96-4104]
  11. Cooper, GS, Yuan Z, Rimm AA.  Racial Disparity in the incidence and case-fatality of colorectal cancer: analysis of 329 United States counties.  Cancer Epidemiology Biomarkers Prev 1997; 6(4): 283-5
  12. Coultas, DB, Gong H Jr., Grad Reuben et al.  State of the art: respiratory diseases in minorities of the United States.  Am J Respir Crit Care Med 1994; 149: S93-S131
  13. Tsark J.  Cancer in Native Hawaiians.  Pacific Health Dialog  1998; 5(2): 315-27.
  14. Susan G. Komen Foundation. Breast health. Hispanic women and breast cancer. 1998.
  15. Ramirez AG, Suarez L. The impact of cancer in Latino population. In: Aguirre-Molina M, Molina C, Zambrana R, editors. Latino health book; 2000 in press.
  16. National Cancer Institute. Cancer facts: breast cancer and mammography facts, 1998.
  17. American Cancer Society. Cancer facts and figures 1997. Available from: URL: http://www.cancer.org/statistics/97cff/97racial.html
  18. Ramirez AG, Suarez L, McAlister A, Villarreal R, Trapido E, Talavera GA, Pérez-Stable E, Marti J. Cervical cancer screening in regional Hispanic populations. Am J Health Behav 2000; 24(3):181-92.
  19. American College of Physicians – American Society of Internal Medicine. No health insurance? It’s enough to make you sick. Latino community at great risk. Philadelphia: College of Physicians – American Society of Internal Medicine; White Paper; 2000. (Available from American College of Physicians – American Society of Internal Medicine, 190 N. Independence Mall West, Philadelphia, PA 19106).
Updated: 08/24/09