Cancer Inequalities in Black Communities: Understanding the Impact and Seeking Solutions

Being told you or someone you love has cancer can be life-changing. Sometimes, you hear about positive outcomes, but that isn’t always everyone’s reality. Cancer’s far-reaching impact extends across diverse populations, especially in Black communities.

Black people are more likely to be diagnosed with and die from cancer when compared to others. This is especially true for breast, lung, prostate, multiple myeloma, and colorectal cancers.¹

Recognizing the differences highlighted by these statistics contributes to a better understanding of how health, culture, and social factors are interconnected and collectively shape the landscape of cancer.

Breast Cancer

Among Black women, breast cancer is the most commonly diagnosed cancer and the second leading cause of cancer-related deaths. Additionally, Black women experience more aggressive forms of breast cancer at younger ages.²

These alarming statistics may be attributed to differences in access to quality healthcare, later-stage diagnoses, and variations in treatment outcomes. Cultural beliefs, mistrust of the healthcare system, and lower participation in clinical trials also contribute to these statistics.

Uncontrollable factors like genetics and differences in tumor biology may also contribute to the variation in disease presentation and outcomes.³

Awareness & Early Detection
Recognizing how wide spread breast cancer is and its specific impact on the Black community emphasizes the importance of early detection. According to the American Cancer Society, women should consider breast cancer screenings as early as age 40.⁴

So, how do you take steps toward reducing your risk of death due to breast cancer?^5,6

• Clinical Breast Exams: Complete routine clinical breast exams as part of regular healthcare check-ups.
• Self Exams: Perform regular self-checks to become familiar with your body and spot any changes quickly. This proactive approach can result in earlier diagnosis and more effective treatment.
• Mammography Screenings: Complete your yearly imaging exam that detects and diagnoses breast cancer.
• Early Intervention: Take early action when abnormalities are found to increase the likelihood of successful treatment and improved outcomes.
• Genetic Counseling: Discuss genetic counseling and testing for specific genes, like BRCA1 and BRCA2, that make you more likely to develop breast cancer. If you have a family history of breast cancer, genetic counseling helps you make informed decisions about your health and family planning.
• Empowerment and Support: Join support groups and online forums to share experiences and provide emotional support.

 
Breast Cancer Treatment
Treatment options for breast cancer have advanced significantly, offering personalized approaches based on your specific needs. For the best outcomes, Black people should seek medical advice promptly and explore treatment options that align with their needs and preferences. Additionally, addressing barriers to treatment, such as financial constraints or transportation issues, is essential to ensure equal access to optimal care.

Prostate Cancer

Black men have the highest rates of prostate cancer in the United States. Like Black women and breast cancer, they’re more likely to be diagnosed and have aggressive forms of prostate cancer. This contributes to a higher death rate among Black men compared to men of other races.⁸

Genetics, such as the BRCA1 and BRCA2 genes, play a role in the increased risk of prostate cancer in Black men.⁹ These gene mutations are known to be involved in fixing DNA and are also linked to breast and ovarian cancers in both men and women.

Additionally, environmental factors like diet, lifestyle, chronic stress, and exposure to toxins contribute to the increased risk. Psychological factors, such as discrimination and socioeconomic stressors, can influence hormonal and immune responses that affect the development and progression of prostate cancer.

Addressing these factors requires a comprehensive approach that promotes healthier dietary choices, encourages active lifestyles, advocates for environmental justice, and ensures equitable access to healthcare and resources.

Screening Guidelines and Treatment Options
Screening for prostate cancer include the PSA (Prostate-Specific Antigen) test and digital rectal exam. Men aged 55 and up should be screened.¹⁰ But, Black men or those with family histories of prostate cancer might need to start screening earlier and undergo more frequent tests.

Treatment options vary based on cancer stage and patient health. These include active surveillance, surgery, radiation, hormone therapy, or chemotherapy. Considering potential side effects and individual preferences helps in treatment decisions.

Lung Cancer

Lung cancer has a particularly heavy impact on the Black population. They are often diagnosed and die at higher rates compared to other racial groups. Black individuals are also more likely to be diagnosed with advanced-stage lung cancer, leading to poorer outcomes.¹¹

Smoking is a main risk factor; historically, higher smoking rates among Black individuals have played a role.¹² However, you can still develop lung cancer without a history of smoking. Exposure to secondhand smoke, indoor and outdoor air pollutants, occupational hazards, and genetic predispositions increase risk.

Efforts for Prevention and Targeted Therapies
Avoiding exposure to smoke helps prevent developing lung cancer. Studies also show quitting smoking improves outcomes for those with lung cancer.¹³ Smoking cessation aids like nicotine replacement products, medications, and lifestyle changes are all effective in quitting smoking. For more information and resources, call 1-800-QUIT-NOW.

Targeted therapies for lung cancer are emerging, focusing on specific genetic mutations that drive cancer growth. These therapies offer more personalized and effective treatment options.

Colorectal Cancer

Colorectal cancer, a disease in which cells in the colon or rectum grow out of control, poses a significant health challenge for Black people. In 2020, Black people accounted for the highest number of new colorectal cancer diagnoses, with Black men responsible for most of these cases.¹⁴
Unfortunately for some, like Chadwick Boseman, they are also diagnosed much earlier.

As with other cancers, specific genes are more prevalent in Black people. But, diets rich in processed foods and low in fiber are also linked to new cases.¹⁵ Additionally, if you have inflammatory bowel disease (IBD) you’re at an increased risk for developing colorectal cancer.

Socioeconomic disparities also limit access to nutritious foods, healthcare services, and preventive screenings, further increasing the risk.

Screening Methods and Treatment Options
Screening for colorectal cancer leads to early detection. Anyone aged 45 to 75 should be screened.¹⁶
Advances in genetic testing can help identify individuals at higher risk and guide personalized screening approaches. Speak with your healthcare provider about your screening options:

• Colonoscopy
• Sigmoidoscopy (sig-moi-dos-kuh-pee)
• Stool-based tests (i.e., Cologuard)

Treating colorectal cancer involves surgery, chemotherapy, radiation, and targeted therapies. The treatment plan considers how far the cancer has spread, your health, and your genes.

Multiple myeloma

Multiple myeloma affects the white blood cells found in your bone marrow. One of these cells, known as plasma cells, make antibodies to help you fight off infections. When these cells start to grow out of control you develop multiple myeloma. It’s not fully understood why someone develops multiple myeloma, but it’s likely linked to genetics. Currently, 1 in every five people diagnosed with multiple myeloma is Black.¹⁷ At this time, there’s no way to prevent developing multiple myeloma. But, obesity is the only risk factor you can help to control. Unfortunately, other factors like age (older than 65), sex (male), and race (black) cannot be changed. Treatment Options and Research Treatment for multiple myeloma is changing rapidly, offering various approaches such as chemotherapy, targeted therapy, stem cell transplantation, and immunotherapy. Clinical trials and research studies aim to develop more effective treatments and personalized approaches for different populations, including Black people.

Common Cancer Treatments

Cancer treatment options have come a long way over the last several decades. Advances in cancer treatment are allowing people to live much longer and healthier lives. For example, when comparing the number of cancer survivors from 1971 to the present, nearly 15 million more people in the US are currently alive.

Some of the treatment options currently available to treat the various forms of cancer include⁷:

• Surgery: Removes tumor and sometimes surrounding tissue and lymph nodes (for example, a lumpectomy for breast cancer).
• Radiation Therapy: Targets energy to destroy cancer cells.
• Chemotherapy: Drugs to kill cancer cells throughout the body.
• Hormone Therapy: Blocks hormones that fuel cancer growth.
• Targeted Therapy: Special drugs targeting specific cancer proteins.
• Immunotherapy: Boost the immune system to fight cancer.
• Adjuvant Therapy: Additional treatment after surgery.
• Palliative Care: Focuses on symptom relief and improving quality of life.

The Bottom Line

In facing the daunting news of a cancer diagnosis, it’s clear that cancer’s impact on Black communities is often more pronounced. The statistics underscore the stark reality that Black people are more frequently diagnosed with cancer and face higher mortality rates. These differences between racial groups echo loudly for breast, lung, prostate, multiple myeloma, and colorectal cancers.

The need for understanding these differences goes beyond numbers. Completing regular screenings and actively participating in support groups significantly improves early detection, treatment outcomes, and the emotional well-being of individuals and their families facing cancer.

Conversation Starters:

• What are your thoughts on the importance of early cancer detection and how it might impact treatment outcomes?
• Do you think there’s enough awareness about the higher rates of cancer diagnosis and death among Black communities, and what do you believe could help address this issue?
• Are you familiar with the different types of cancer screenings available? How could promoting early detection improve outcomes, especially in communities facing disparities?

References

1. Centers for Disease Control and Prevention. African American People and Cancer. www.cdc.gov. Published January 31, 2023. https://www.cdc.gov/cancer/health-equity/groups/african-american.htm
2. McDowell S. Breast Cancer Death Rates Are Highest for Black Women—Again | Breast Cancer Facts & Figures, 2022-2024. www.cancer.org. https://www.cancer.org/research/acs-research-news/breast-cancer-death-rates-are-highest-for-black-women-again.html
3. Yedjou CG, Sims JN, Miele L, et al. Health and Racial Disparity in Breast Cancer. Adv Exp Med Biol. 2019;1152:31-49. doi:10.1007/978-3-030-20301-6_3
4. American Cancer Society. Cancer Screening Guidelines | Detecting Cancer Early. www.cancer.org. https://www.cancer.org/cancer/screening/american-cancer-society-guidelines-for-the-early-detection-of-cancer.html#:~:text=Women%20ages%2040%20to%2044
5. National Cancer Institute. Breast Cancer Screening. National Cancer Institute. Published June 6, 2019. https://www.cancer.gov/types/breast/hp/breast-screening-pdq
6. Center for Disease Control and Prevention. Genetic Counseling for Hereditary Breast and Ovarian Cancer | CDC. www.cdc.gov. Published March 31, 2020. https://www.cdc.gov/genomics/disease/breast_ovarian_cancer/counseling.htm
7. National Breast Cancer Foundation. Treatment. National Breast Cancer Foundation. Published 2019. https://www.nationalbreastcancer.org/breast-cancer-treatment/
8. 3 Things Black Men Should Know about Prostate Cancer | Memorial Sloan Kettering Cancer Center. www.mskcc.org. https://www.mskcc.org/news/things-black-men-should-know-about-prostate
9. Ledet EM, Burgess EF, Sokolova AO, et al. Comparison of germline mutations in African American and Caucasian men with metastatic prostate cancer. Prostate. 2021;81(7):433-439. doi:10.1002/pros.24123
10. Prostate Cancer: Age-Specific Screening Guidelines. www.hopkinsmedicine.org. https://www.hopkinsmedicine.org/health/conditions-and-diseases/prostate-cancer/prostate-cancer-age-specific-screening-guidelines
11. ‌State of Lung Cancer | Racial and Ethnic Disparities. www.lung.org. https://www.lung.org/research/state-of-lung-cancer/racial-and-ethnic-disparities
12. Arauz RF, Mayer M, Reyes-Guzman C, Ryan BM. Racial Disparities in Cigarette Smoking Behaviors and Differences Stratified by Metropolitan Area of Residence. Int J Environ Res Public Health. 2022;19(5):2910. Published 2022 Mar 2. doi:10.3390/ijerph19052910
13. Wang X, Romero-Gutierrez CW, Kothari J, Shafer A, Li Y, Christiani DC. Prediagnosis Smoking Cessation and Overall Survival Among Patients With Non-Small Cell Lung Cancer. JAMA Netw Open. 2023;6(5):e2311966. Published 2023 May 1. doi:10.1001/jamanetworkopen.2023.11966
14. Centers for Disease Control and Prevention. USCS Data Visualizations. gis.cdc.gov. Published 2019. https://gis.cdc.gov/Cancer/USCS/#/Demographics/
15. ‌Hullings AG, Sinha R, Liao LM, Freedman ND, Graubard BI, Loftfield E. Whole grain and dietary fiber intake and risk of colorectal cancer in the NIH-AARP Diet and Health Study cohort. Am J Clin Nutr. 2020;112(3):603-612. doi:10.1093/ajcn/nqaa161
16. U.S. Preventive Services Task Force. Recommendation | United States Preventive Services Taskforce. www.uspreventiveservicestaskforce.org. Published May 18, 2021. https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/colorectal-cancer-screening
17. ‌Disparities in African Americans. International Myeloma Foundation. https://www.myeloma.org/IMF-Diversity-Equity-Inclusion-Policy/disparities-african-americans