Inequality and Cancer
From the American Cancer Society:
The death rate from cancer in the US has declined steadily over the past 25 years, according to annual statistics reporting from the American Cancer Society. As of 2016, the cancer death rate for men and women combined had fallen 27% from its peak in 1991. This decline translates to about 1.5% per year and more than 2.6 million deaths avoided between 1991 and 2016.
The drop in cancer mortality is mostly due to steady reductions in smoking and advances in early detection and treatment. But not all populations are benefitting. Although the racial gap in cancer deaths is slowly narrowing, socioeconomic inequalities are widening. “Cancer Statistics, 2019,” published in the American Cancer Society’s journal CA: A Cancer Journal for Clinicians, estimates the numbers of new cancer cases and deaths expected in the US this year. The estimates are some of the most widely quoted cancer statistics in the world. The information is also released in a companion report, Cancer Facts and Figures 2019, available on the interactive website, the Cancer Statistics Center.
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The rates of new cancer cases and cancer deaths vary quite a bit among racial and ethnic groups, with rates generally highest among African Americans and lowest for Asian Americans. The cancer death rate in 2016 was 14% higher in blacks than in whites. That gap has narrowed from a peak of 33% in 1993. The progress is due to the steep drop in smoking rates among black teens from the late 1970s through the early 1990s.
Racial and ethnic differences in cancer burden reflect several factors related to socioeconomic status. People living in the poorest counties in the US are more likely to smoke and be obese. During 2012-2016, death rates in the poorest counties were 2 times higher for cervical cancer and 40% higher for male lung and liver cancers, compared with the richest counties. Poverty is also associated with lower rates of routine cancer screening, later stage at diagnosis, and a lower likelihood of getting the best treatment.
