Cancer Care

Prostate

A major type of cancer affecting older African American men is prostate cancer, in which they have a 60% excess incidence (Richardson, 1996). Black non-Hispanic males have been found to have twice the risk of prostate cancer as Black Hispanic men (Manton, 1997).

Breast

Breast cancer incidence seems to be about the same or lower for African American women as other women, but the survival rate is lower. The survival rates appear to be improving, but the stage at which the tumor is diagnosed is still later for Black women.

Factors associated with the late stage diagnosis are:

• limited access to care
• care in public rather than private clinics
• higher body mass index
• lower rates of mammography

Breast cancer continues to be diagnosed at later stages of the illness in African American women compared to white women. A new study suggests that poorer communication of mammogram results may not allow black women to benefit fully from mammography screening and may underlie their later diagnosis of breast cancer (Jones et al. 2007).

The investigators reported that communication of mammogram results was problematic for 14.5 percent of the women in the study (12.5 percent had not received their screening result, and 2 percent had received their result, but their self-report differed from the radiology record).

Inadequate communication of mammogram results was nearly twice as common among black women as white women (21 vs. 11 percent), even after adjustment for other sociodemographic, clinical, and care access factors. Also, abnormal results were more likely to be inadequately communicated to black women (31 percent of abnormal results vs. 19 percent of normal results), but not to white women.

Among women in the study who had abnormal results, 44 percent of those in the inadequate communication group (many of whom believed their mammogram was normal) compared with 29 percent of those in the adequate communication group did not receive adequate follow-up.

Cervical

Cervical cancer risk is higher among African American women (Manton, 1997). Incidence and mortality for multiple myeloma cancer among Blacks are twice that among Whites, and the risk increases with age. (For complete discussion of causes of racial differences in cancers see Manton and Stallard, 1997).

Survival Rates

Click to View Figure 2

Figure 2 shows a comparison of cancer survival rates between Black and White patients. With the exception of Mesothelioma, Blacks tend to have a lower survival rate than Whites. Sizable disparities are seen in Breast, Corpus & Uterus, NOS, Larynx, Non-Hodgkin Lymphoma, Oral Cavity & Pharynx and Kaposi Sarcoma.