Gap Continues in African American Deaths from Colorectal Cancer

Although both new cancer cases and cancer death rates are declining for both whites and African Americans, incidence and death rates continue to remain higher for blacks in the United States than for whites.  African American men are one-third more likely to die of cancer than whites, black women 16 percent more likely.

While five-year survival for white Americans with colon or rectal cancer is 65 percent, it is only 56 percent for blacks.  Blacks have poorer survival chances at every stage of colorectal cancer, including the earliest stages where cancer has not begun to spread.

Compared to lung, prostate,and breast cancer where the disparity gaps in death rates are narrowing, differences in colorectal cancer mortality are growing.

According to the American Cancer Society, 16,520 African Americans, 7,986 men and 8,540 women, will be diagnosed with colorectal cancer in 2009, and 7,120 will die.

Since the early 1980’s the gap in colorectal cancer death rates between blacks and whites has grown.  While there has been a decline in death rates for both black and whites, the white decline has been steeper.  In 1975-77, 46 percent of blacks lived five years past a colorectal cancer diagnosis.  That rose to 56 percent in the period between 1996 and 2004, but didn’t equal the change for whites that increased from 51 percent to 66 percent.

  • Blacks are more likely to have diagnosis delayed until cancer has spread to distant sites in the body.  One in four blacks will be diagnosed with stage IV or metastatic colorectal cancer, compared to one in five whites.  Once their cancer has spread, 8 percent of blacks and 11 percent of whites will survive five years.
  • Even at early localized diagnosis, 84 percent of blacks will live for five years compared to 90 percent of whites.
  • Colorectal cancer screening lags for African Americans.  In 2005, 40 percent had been screened with either fecal occult blood test or endoscopy compared to just under 50 percent of whites.  Thirty-seven percent had had a colonoscopy or sigmoidoscopy compared to 46 percent of whites.

Colorectal cancer screening differences are much wider than mammograms where differences were about 3 percent or cervical cancer PAP testing with no significant differences between black and white women.

Researchers point to other complex socioeconomic and insurance issues, as well as differences in getting recommended surgical and chemotherapy treatment contributing to disparities in survival.  Almost twice as many African Americans are uninsured (21 percent) as whites (11 percent).

SOURCE: American Cancer Society, Cancer Facts and Figures for African Americans 2009-2010.

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