[ad_1]
“Black people have lower survival than white people at every stage of diagnosis for almost every type of cancer, largely because Black men and women receive less high quality care,” said Rebecca Siegel, MPH, the senior scientific director of surveillance research at the ACS and the lead author of the recent report.
Indeed, the ACS determined that racial disparities in cancer death rates and survival times are largely a consequence of less access to high-quality care across the cancer continuum, from prevention to screening to treatment.
The report also calls out systemic inequities, such as long-standing wealth inequality, which in turn have led to differences in risk-factor exposures and access to early detection and treatment.
Here, a breakdown of the leading barriers identified by the report to equitable cancer care for Black Americans in the United States.
Lack of Health Insurance
Socioeconomic status has been flagged as a leading contributor to disparities in cancer care, and according to the ACS, the socioeconomic factor that most affects cancer care is inadequate health insurance.
More than 14 percent of Black Americans lack health insurance, compared with 10 percent of white Americans and 7 percent of Asian Americans, according to the American Association for Cancer Research’s (AACR) 2022 Cancer Progress Report.
“African Americans continue to have a disproportionate burden of cancer mortality largely because of lack of health insurance and other socioeconomic barriers that limit access to cancer prevention and care,” said?Karen Knudsen, MD, the chief executive officer of the ACS.
Insufficient Screening
This one follows lack of health insurance, which often translates to lack of cancer screening. The best way to survive cancer is to prevent it or catch it early via screenings such as colonoscopy and mammograms.
Research shows, however, that people without health insurance are less likely to be up-to-date on cancer screenings and, as a result, are more likely to be diagnosed with cancer at an advanced stage, when it’s harder to treat.
In 2018, just 30 percent of women without health insurance were up-to-date with recommended breast cancer screening, compared with 68 percent of women with insurance, according to the report. Black women are more likely than any other racial or ethnic group to die of breast cancer, according to the ACS.
In the case of colorectal cancer — a leading cancer killer in the Black community — research shows that while appropriate screening can reduce the risk of death by more than 50 percent, Black men and women are screened less than their white counterparts.
Racism
In addition to the lack of access to quality care, when health visits do occur, Black American patients tend to report worse patient-provider interactions than white patients. One study found that about a third of African American women reported experiencing racial discrimination at a provider visit, according to the ACS.
African Americans are also not adequately represented in clinical trials. Researchers have found that physicians are less likely to discuss clinical studies with minority patients, but that when providers mention the opportunity, Black adults participate at rates similar to white adults.
“Racial and ethnic minorities and other medically underserved populations are underrepresented in clinical studies that evaluate the efficacy of anti-cancer treatments, which can potentially contribute to higher cancer mortality and morbidity,” notes the AACR report.
Lifestyle and Environment
The conditions in which people are born, grow, live, work, and age have been strongly and consistently associated with life expectancy and disease. These factors, which are referred to as “social determinants of health,” correlate with environmental cancer risk factors such as air pollution, as well as behavioral risk factors, such as smoking and obesity, which is a known risk factor for 13 different types of cancer, including breast and colorectal cancers, which top the list of cancer killers of Black women and men.
Decades of structural, social, and institutional injustices place disadvantaged populations in unfavorable living environments with higher exposure to environmental carcinogens like pollution, and in areas lacking grocery stores and markets that offer fresh, healthful foods. Systemic inequality also contributes to behaviors that increase cancer risk, such as smoking and alcohol consumption, according to the AACR report.
Barriers Can Be Overcome, Risks Modified
While the barriers to cancer care in the United States are both long-standing and systemic, but they’re not intractable. “Even though these factors continue to persist and are the result of structural racism, they can be resolved,” said Wayne R. Lawrence, MPH, DrPH, a research fellow in the metabolic epidemiology branch of the division of cancer epidemiology and genetics at the NCI.
Indeed, this has already begun to happen, to some degree. While cancer rates among Black Americans remain disproportionately high, the disparity in overall cancer deaths between Black and white Americans narrowed from 26 percent in 2000 to 13 percent in 2019, according to the AACR report.
A reduction in lung cancer deaths is a leading reason for the narrowing of that gap. Smoking-related lung cancer mortality is down among all racial and ethnic groups but has declined faster among Black Americans. Experts credit effective smoking-cessation campaigns over the past five decades.
If lung cancer, one of the leading killers of all Americans, can fall to intervention, other cancers can, too.
[ad_2]
Source link
