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. 1995 Nov;103(Suppl 8):275–281. doi: 10.1289/ehp.95103s8275

Differences in cancer incidence, mortality, and survival between African Americans and whites.

B Walker 1, L W Figgs 1, S H Zahm 1
PMCID: PMC1518956  PMID: 8741798

Abstract

This report highlights selected evidence of different cancer patterns among African Americans and whites and considers potential risk factors associated with these cancers. During the years 1987 to 1991, African Americans experienced higher incidence and mortality rates than whites for multiple myeloma and for cancers of the oropharynx, colorectum, lung and bronchus, cervix, and prostate. African Americans had lower incidence and mortality for cancer of the urinary bladder. The incidence of breast cancer was higher among white women, but mortality was higher among African American women. Five-year relative survival for the period 1983 to 1990 was generally lower among African Americans than whites for cancers of the oropharynx, colorectum, cervix, prostate, and female breast but slightly higher for multiple myeloma. From 1973 to 1991, there were significant declines in cervical cancer incidence among women of both races, oropharyngeal cancer mortality among whites, and bladder cancer mortality for whites and African Americans. Risk factors for the more prominent cancers suggest that efforts aimed at changing lifestyles, achieving socioeconomic parity, and insuring environmental equity are likely to relieve African Americans of much of their disproportionate cancer burden.

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Selected References

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  1. Barrett-Connor E. Postmenopausal estrogen and the risk of breast cancer. Ann Epidemiol. 1994 May;4(3):177–180. doi: 10.1016/1047-2797(94)90094-9. [DOI] [PubMed] [Google Scholar]
  2. Bergner L. Race, health, and health services. Am J Public Health. 1993 Jul;83(7):939–941. doi: 10.2105/ajph.83.7.939. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Brawn P. N., Johnson E. H., Speights V. O., Riggs M., Kuhl D., Abel P. D., Lind M., Bell N. Incidence, racial differences, and prognostic significance of prostate carcinomas diagnosed with obstructive symptoms. Cancer. 1994 Sep 1;74(5):1607–1611. doi: 10.1002/1097-0142(19940901)74:5<1607::aid-cncr2820740518>3.0.co;2-f. [DOI] [PubMed] [Google Scholar]
  4. Brown M. L., Kessler L. G., Rueter F. G. Is the supply of mammography machines outstripping need and demand? An economic analysis. Ann Intern Med. 1990 Oct 1;113(7):547–552. doi: 10.7326/0003-4819-113-7-547. [DOI] [PubMed] [Google Scholar]
  5. Caplan L. S., Wells B. L., Haynes S. Breast cancer screening among older racial/ethnic minorities and whites: barriers to early detection. J Gerontol. 1992 Nov;47(Spec No):101–110. [PubMed] [Google Scholar]
  6. Day G. L., Blot W. J., Austin D. F., Bernstein L., Greenberg R. S., Preston-Martin S., Schoenberg J. B., Winn D. M., McLaughlin J. K., Fraumeni J. F., Jr Racial differences in risk of oral and pharyngeal cancer: alcohol, tobacco, and other determinants. J Natl Cancer Inst. 1993 Mar 17;85(6):465–473. doi: 10.1093/jnci/85.6.465. [DOI] [PubMed] [Google Scholar]
  7. Dosemeci M., Hoover R. N., Blair A., Figgs L. W., Devesa S., Grauman D., Fraumeni J. F., Jr Farming and prostate cancer among African-Americans in the southeastern United States. J Natl Cancer Inst. 1994 Nov 16;86(22):1718–1719. doi: 10.1093/jnci/86.22.1718. [DOI] [PubMed] [Google Scholar]
  8. Eley J. W., Hill H. A., Chen V. W., Austin D. F., Wesley M. N., Muss H. B., Greenberg R. S., Coates R. J., Correa P., Redmond C. K. Racial differences in survival from breast cancer. Results of the National Cancer Institute Black/White Cancer Survival Study. JAMA. 1994 Sep 28;272(12):947–954. doi: 10.1001/jama.272.12.947. [DOI] [PubMed] [Google Scholar]
  9. Feldman J. J., Makuc D. M., Kleinman J. C., Cornoni-Huntley J. National trends in educational differentials in mortality. Am J Epidemiol. 1989 May;129(5):919–933. doi: 10.1093/oxfordjournals.aje.a115225. [DOI] [PubMed] [Google Scholar]
  10. Field N. A., Baptiste M. S., Nasca P. C., Metzger B. B. Cigarette smoking and breast cancer. Int J Epidemiol. 1992 Oct;21(5):842–848. doi: 10.1093/ije/21.5.842. [DOI] [PubMed] [Google Scholar]
  11. Figgs L. W., Dosemeci M., Blair A. Risk of multiple myeloma by occupation and industry among men and women: a 24-state death certificate study. J Occup Med. 1994 Nov;36(11):1210–1221. doi: 10.1097/00043764-199411000-00007. [DOI] [PubMed] [Google Scholar]
  12. Finkelstein S. D., Sayegh R., Christensen S., Swalsky P. A. Genotypic classification of colorectal adenocarcinoma. Biologic behavior correlates with K-ras-2 mutation type. Cancer. 1993 Jun 15;71(12):3827–3838. doi: 10.1002/1097-0142(19930615)71:12<3827::aid-cncr2820711207>3.0.co;2-n. [DOI] [PubMed] [Google Scholar]
  13. Futreal P. A., Liu Q., Shattuck-Eidens D., Cochran C., Harshman K., Tavtigian S., Bennett L. M., Haugen-Strano A., Swensen J., Miki Y. BRCA1 mutations in primary breast and ovarian carcinomas. Science. 1994 Oct 7;266(5182):120–122. doi: 10.1126/science.7939630. [DOI] [PubMed] [Google Scholar]
  14. Hayes R. B., Pottern L. M., Greenberg R., Schoenberg J., Swanson G. M., Liff J., Schwartz A. G., Brown L. M., Hoover R. N. Vasectomy and prostate cancer in US blacks and whites. Am J Epidemiol. 1993 Feb 1;137(3):263–269. doi: 10.1093/oxfordjournals.aje.a116673. [DOI] [PubMed] [Google Scholar]
  15. Hayes R. B., Pottern L. M., Swanson G. M., Liff J. M., Schoenberg J. B., Greenberg R. S., Schwartz A. G., Brown L. M., Silverman D. T., Hoover R. N. Tobacco use and prostate cancer in blacks and whites in the United States. Cancer Causes Control. 1994 May;5(3):221–226. doi: 10.1007/BF01830240. [DOI] [PubMed] [Google Scholar]
  16. Howe G. R. Dietary fat and breast cancer risks. An epidemiologic perspective. Cancer. 1994 Aug 1;74(3 Suppl):1078–1084. doi: 10.1002/1097-0142(19940801)74:3+<1078::aid-cncr2820741516>3.0.co;2-h. [DOI] [PubMed] [Google Scholar]
  17. Hulka B. S., Liu E. T., Lininger R. A. Steroid hormones and risk of breast cancer. Cancer. 1994 Aug 1;74(3 Suppl):1111–1124. doi: 10.1002/1097-0142(19940801)74:3+<1111::aid-cncr2820741520>3.0.co;2-l. [DOI] [PubMed] [Google Scholar]
  18. Hunter C. P., Redmond C. K., Chen V. W., Austin D. F., Greenberg R. S., Correa P., Muss H. B., Forman M. R., Wesley M. N., Blacklow R. S. Breast cancer: factors associated with stage at diagnosis in black and white women. Black/White Cancer Survival Study Group. J Natl Cancer Inst. 1993 Jul 21;85(14):1129–1137. doi: 10.1093/jnci/85.14.1129. [DOI] [PubMed] [Google Scholar]
  19. Kato S., Shields P. G., Caporaso N. E., Sugimura H., Trivers G. E., Tucker M. A., Trump B. F., Weston A., Harris C. C. Analysis of cytochrome P450 2E1 genetic polymorphisms in relation to human lung cancer. Cancer Epidemiol Biomarkers Prev. 1994 Sep;3(6):515–518. [PubMed] [Google Scholar]
  20. Kelsey J. L., Gammon M. D., John E. M. Reproductive factors and breast cancer. Epidemiol Rev. 1993;15(1):36–47. doi: 10.1093/oxfordjournals.epirev.a036115. [DOI] [PubMed] [Google Scholar]
  21. Krieger N. Social class and the black/white crossover in the age-specific incidence of breast cancer: a study linking census-derived data to population-based registry records. Am J Epidemiol. 1990 May;131(5):804–814. doi: 10.1093/oxfordjournals.aje.a115571. [DOI] [PubMed] [Google Scholar]
  22. Krieger N., Wolff M. S., Hiatt R. A., Rivera M., Vogelman J., Orentreich N. Breast cancer and serum organochlorines: a prospective study among white, black, and Asian women. J Natl Cancer Inst. 1994 Apr 20;86(8):589–599. doi: 10.1093/jnci/86.8.589. [DOI] [PubMed] [Google Scholar]
  23. Lacey L. Cancer prevention and early detection strategies for reaching underserved urban, low-income black women. Barriers and objectives. Cancer. 1993 Aug 1;72(3 Suppl):1078–1083. doi: 10.1002/1097-0142(19930801)72:3+<1078::aid-cncr2820721323>3.0.co;2-7. [DOI] [PubMed] [Google Scholar]
  24. Lewis D. R., Pottern L. M., Brown L. M., Silverman D. T., Hayes R. B., Schoenberg J. B., Greenberg R. S., Swanson G. M., Schwartz A. G., Liff J. M. Multiple myeloma among blacks and whites in the United States: the role of chronic antigenic stimulation. Cancer Causes Control. 1994 Nov;5(6):529–539. doi: 10.1007/BF01831381. [DOI] [PubMed] [Google Scholar]
  25. Liff J. M., Chow W. H., Greenberg R. S. Rural-urban differences in stage at diagnosis. Possible relationship to cancer screening. Cancer. 1991 Mar 1;67(5):1454–1459. doi: 10.1002/1097-0142(19910301)67:5<1454::aid-cncr2820670533>3.0.co;2-k. [DOI] [PubMed] [Google Scholar]
  26. Lloyd J. W. Long-term mortality study of steelworkers. V. Respiratory cancer in coke plant workers. J Occup Med. 1971 Feb;13(2):53–68. [PubMed] [Google Scholar]
  27. Marmot M. G., Kogevinas M., Elston M. A. Social/economic status and disease. Annu Rev Public Health. 1987;8:111–135. doi: 10.1146/annurev.pu.08.050187.000551. [DOI] [PubMed] [Google Scholar]
  28. Mayberry R. M. Age-specific patterns of association between breast cancer and risk factors in black women, ages 20 to 39 and 40 to 54. Ann Epidemiol. 1994 May;4(3):205–213. doi: 10.1016/1047-2797(94)90098-1. [DOI] [PubMed] [Google Scholar]
  29. McWhorter W. P., Schatzkin A. G., Horm J. W., Brown C. C. Contribution of socioeconomic status to black/white differences in cancer incidence. Cancer. 1989 Mar 1;63(5):982–987. doi: 10.1002/1097-0142(19890301)63:5<982::aid-cncr2820630533>3.0.co;2-i. [DOI] [PubMed] [Google Scholar]
  30. Mettlin C. J., Murphy G. The National Cancer Data Base report on prostate cancer. Cancer. 1994 Sep 1;74(5):1640–1648. doi: 10.1002/1097-0142(19940901)74:5<1640::aid-cncr2820740525>3.0.co;2-3. [DOI] [PubMed] [Google Scholar]
  31. Miki Y., Swensen J., Shattuck-Eidens D., Futreal P. A., Harshman K., Tavtigian S., Liu Q., Cochran C., Bennett L. M., Ding W. A strong candidate for the breast and ovarian cancer susceptibility gene BRCA1. Science. 1994 Oct 7;266(5182):66–71. doi: 10.1126/science.7545954. [DOI] [PubMed] [Google Scholar]
  32. Nomura A. M., Kolonel L. N. Prostate cancer: a current perspective. Epidemiol Rev. 1991;13:200–227. doi: 10.1093/oxfordjournals.epirev.a036069. [DOI] [PubMed] [Google Scholar]
  33. Pappas G., Queen S., Hadden W., Fisher G. The increasing disparity in mortality between socioeconomic groups in the United States, 1960 and 1986. N Engl J Med. 1993 Jul 8;329(2):103–109. doi: 10.1056/NEJM199307083290207. [DOI] [PubMed] [Google Scholar]
  34. Pike M. C., Spicer D. V., Dahmoush L., Press M. F. Estrogens, progestogens, normal breast cell proliferation, and breast cancer risk. Epidemiol Rev. 1993;15(1):17–35. doi: 10.1093/oxfordjournals.epirev.a036102. [DOI] [PubMed] [Google Scholar]
  35. Potter J. D., Slattery M. L., Bostick R. M., Gapstur S. M. Colon cancer: a review of the epidemiology. Epidemiol Rev. 1993;15(2):499–545. doi: 10.1093/oxfordjournals.epirev.a036132. [DOI] [PubMed] [Google Scholar]
  36. Pottern L. M., Gart J. J., Nam J. M., Dunston G., Wilson J., Greenberg R., Schoenberg J., Swanson G. M., Liff J., Schwartz A. G. HLA and multiple myeloma among black and white men: evidence of a genetic association. Cancer Epidemiol Biomarkers Prev. 1992 Mar-Apr;1(3):177–182. [PubMed] [Google Scholar]
  37. Riedel D. A., Pottern L. M. The epidemiology of multiple myeloma. Hematol Oncol Clin North Am. 1992 Apr;6(2):225–247. [PubMed] [Google Scholar]
  38. Satariano W. A., Swanson G. M. Racial differences in cancer incidence: the significance of age-specific patterns. Cancer. 1988 Dec 15;62(12):2640–2653. doi: 10.1002/1097-0142(19881215)62:12<2640::aid-cncr2820621233>3.0.co;2-g. [DOI] [PubMed] [Google Scholar]
  39. Schairer C., Hartge P., Hoover R. N., Silverman D. T. Racial differences in bladder cancer risk: a case-control study. Am J Epidemiol. 1988 Nov;128(5):1027–1037. doi: 10.1093/oxfordjournals.aje.a115047. [DOI] [PubMed] [Google Scholar]
  40. Schatzkin A., Longnecker M. P. Alcohol and breast cancer. Where are we now and where do we go from here? Cancer. 1994 Aug 1;74(3 Suppl):1101–1110. doi: 10.1002/1097-0142(19940801)74:3+<1101::aid-cncr2820741519>3.0.co;2-x. [DOI] [PubMed] [Google Scholar]
  41. Schuman L. M., Mandel J., Blackard C., Bauer H., Scarlett J., McHugh R. Epidemiologic study of prostatic cancer: preliminary report. Cancer Treat Rep. 1977 Mar-Apr;61(2):181–186. [PubMed] [Google Scholar]
  42. Shields P. G., Caporaso N. E., Falk R. T., Sugimura H., Trivers G. E., Trump B. F., Hoover R. N., Weston A., Harris C. C. Lung cancer, race, and a CYP1A1 genetic polymorphism. Cancer Epidemiol Biomarkers Prev. 1993 Sep-Oct;2(5):481–485. [PubMed] [Google Scholar]
  43. Sorlie P., Rogot E., Anderson R., Johnson N. J., Backlund E. Black-white mortality differences by family income. Lancet. 1992 Aug 8;340(8815):346–350. doi: 10.1016/0140-6736(92)91413-3. [DOI] [PubMed] [Google Scholar]
  44. Spitz M. R., Currier R. D., Fueger J. J., Babaian R. J., Newell G. R. Familial patterns of prostate cancer: a case-control analysis. J Urol. 1991 Nov;146(5):1305–1307. doi: 10.1016/s0022-5347(17)38074-6. [DOI] [PubMed] [Google Scholar]
  45. Steele G. D., Jr The National Cancer Data Base report on colorectal cancer. Cancer. 1994 Oct 1;74(7):1979–1989. doi: 10.1002/1097-0142(19941001)74:7<1979::aid-cncr2820740725>3.0.co;2-j. [DOI] [PubMed] [Google Scholar]
  46. Steinberg G. D., Carter B. S., Beaty T. H., Childs B., Walsh P. C. Family history and the risk of prostate cancer. Prostate. 1990;17(4):337–347. doi: 10.1002/pros.2990170409. [DOI] [PubMed] [Google Scholar]
  47. Swanson G. M., Ragheb N. E., Lin C. S., Hankey B. F., Miller B., Horn-Ross P., White E., Liff J. M., Harlan L. C., McWhorter W. P. Breast cancer among black and white women in the 1980s. Changing patterns in the United States by race, age, and extent of disease. Cancer. 1993 Aug 1;72(3):788–798. doi: 10.1002/1097-0142(19930801)72:3<788::aid-cncr2820720326>3.0.co;2-c. [DOI] [PubMed] [Google Scholar]
  48. Swanson G. M., Satariano E. R., Satariano W. A., Threatt B. A. Racial differences in the early detection of breast cancer in metropolitan Detroit, 1978 to 1987. Cancer. 1990 Sep 15;66(6):1297–1301. doi: 10.1002/1097-0142(19900915)66:6<1297::aid-cncr2820660633>3.0.co;2-m. [DOI] [PubMed] [Google Scholar]
  49. Terris M. Desegregating health statistics. Am J Public Health. 1973 Jun;63(6):477–480. doi: 10.2105/ajph.63.6.477. [DOI] [PMC free article] [PubMed] [Google Scholar]
  50. Walker A. R., Walker B. F., Segal I. Cancer patterns in three African populations compared with the United States black population. Eur J Cancer Prev. 1993 Jul;2(4):313–320. doi: 10.1097/00008469-199307000-00005. [DOI] [PubMed] [Google Scholar]
  51. Weston A., Ling-Cawley H. M., Caporaso N. E., Bowman E. D., Hoover R. N., Trump B. F., Harris C. C. Determination of the allelic frequencies of an L-myc and a p53 polymorphism in human lung cancer. Carcinogenesis. 1994 Apr;15(4):583–587. doi: 10.1093/carcin/15.4.583. [DOI] [PubMed] [Google Scholar]
  52. Weston A., Perrin L. S., Forrester K., Hoover R. N., Trump B. F., Harris C. C., Caporaso N. E. Allelic frequency of a p53 polymorphism in human lung cancer. Cancer Epidemiol Biomarkers Prev. 1992 Sep-Oct;1(6):481–483. [PubMed] [Google Scholar]
  53. White E., Malone K. E., Weiss N. S., Daling J. R. Breast cancer among young U.S. women in relation to oral contraceptive use. J Natl Cancer Inst. 1994 Apr 6;86(7):505–514. doi: 10.1093/jnci/86.7.505. [DOI] [PubMed] [Google Scholar]

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