Cancer Health Disparities in America
Cancer health disparities are differences in the incidence, prevalence, and burden of
cancer that exist among specific populations in the U.S., as noted in the table below.
Research shows that advances in cancer care do not equally benefit all Americans.
Gaps along the entire cancer care continuum—from prevention, to screening and
diagnosis, to treatment and follow-up services—are well-documented, most notably
among cancer patients from certain racial and ethnic minority groups, individuals
with low socioeconomic status, residents in certain geographic locations, the elderly,
and individuals from other medically underserved groups (see also Sidebar on
Aging, p. 65).
Understanding the complex, multifaceted nature of cancer health disparities must
continue to be a central component of the Nation’s research agenda.
American Indian/Alaska Native
National Cancer Institute: Statistics are for 2000-2004 and represent the number of new
cases of invasive cancer and deaths per year per 100,000 men and women29.
It is important to consider the following disparities in cancer incidence:
• Lung cancer rates among Southeast Asians are 18% higher than among white
Americans. Most cases of lung cancer among East Asian women occur among
never smokers, suggesting that genetic and/or environmental risk factors are
• Triple negative breast cancer, a more aggressive cancer for which there are no
targeted therapies, accounts for 26% of breast cancer cases in African American
women, significantly higher than the 16% of breast cancer among all other
• African American men and women have higher rates of colorectal cancer than their
white counterparts ( 62. 1 versus 51. 2 per 100,000).
• Hispanic and African American women have a much higher incidence of cervical
cancer than white women ( 13. 8 and 11. 4 versus 8. 5 per 100,000).
• Asian Americans are twice more likely to suffer from liver and stomach cancer than
the general population. Korean men experience a rate of stomach cancer 5 times
higher than that of white men. Initial studies suggest the higher rates of H. pylori
infection may explain, in part, why Asian/Pacific Islander populations have higher
rates for these cancers.
• American Indian/Alaska Native men are 80% more likely to have liver and
intrahepatic bile duct cancer than non-Hispanic white men.
• American Indian/Alaska Native men are nearly twice as likely to have stomach
cancer as non-Hispanic white men ( 15. 5 versus 8. 8 per 100,000).
• The incidence rate for leukemia, the most common childhood cancer, is
approximately 17% higher among Hispanic children, compared to white children.
• American Indians/Alaska Natives have higher rates of kidney and renal pelvis
cancer than their white counterparts ( 14. 1 versus 10. 2 women; 21. 2 versus 20. 1
men per 100,000).
Disparities are also apparent in the survival rates of specific populations:
• A 2006 analysis showed that cancer mortality rates in most Appalachian states
were higher than the national average of about 181 people out of every 100,000. In
fact, 6 of the 7 states with the highest cancer death rates are part of this region
(KY-212, MS-211, WV-207, TN-204, AL-199, and OH-198, per 100,000 residents).
• A genetic component related to Native Americans and Hispanics of Native
American descent corresponds to a higher rate of relapse during chemotherapy
treatment for acute lymphocytic leukemia (24% chance of relapse versus 17% for
• Although white women tend to have a higher incidence of breast cancer than
African- American women (111.8 versus 95.4 per 100,000), the mortality rate is
higher among the latter ( 22. 4 versus 33. 5 per 100,000).
• African American men have far higher death rates from prostate cancer than any
other racial or ethnic group, and are 2. 4 times more likely to die of this cancer than
white men. Multiple genetic variants have been associated with increased and
decreased risks of prostate cancer. Nearly all variants associated with an increased
risk of developing prostate cancer were found in African American men, with
certain combinations corresponding to a nearly 5-fold increase in risk of prostate
cancer in this racial group.
• African Americans suffer the highest rate of colorectal and lung/bronchus cancer
deaths ( 26. 7 and 62.0 per 100,000), while Hispanic/Latinos rates are nearly 50%
lower ( 13. 6 and 23. 6 per 100,000).
• American Indian/Alaska Native men are more than twice as likely to die from
stomach cancer as non-Hispanic white men.
The most common factors causing these health disparities are a lack of healthcare
access and low socioeconomic status the latter, which is linked to tobacco use,
physical inactivity, poor diet, and lower literacy rates. While data suggest that access
to care is a key factor, it is also clear that tumor biology, genetics, lifestyle, and
environmental exposures also contribute to these disparities. Therefore, it is critical
that researchers continue to investigate the reasons for these disparities and develop
effective interventions that can mitigate them. We must better understand how all of
these factors can be overcome, and develop effective interventions and evidence-based policies to improve prevention strategies and secure access to quality cancer
care for all Americans in need.
Should we fail to address this problem, cancer will continue to remain a disease that
disproportionately affects certain populations, and the disparities that we see today
in a growing U.S. population will become even more pronounced in the future.