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As people commemorate Black History Month and reflect on the achievements and contributions of Black individuals throughout history, it is crucial to acknowledge the health disparities that persist within the Black community. Against this backdrop, February 4, 2024, marked World Cancer Day, providing an opportune time to explore the intricate intersection of cancer and race, particularly the disproportionate impact on the Black population.
Dissecting the disparities
According to data from the Centers for Disease Control and Prevention (CDC), Black and African American individuals face higher rates of both cancer incidence and mortality compared to other racial groups.
CDC further states that Black people have the highest death rate for cancer overall, coupled with a lower overall 5-year cancer survival rate than their white counterparts.
The threat of prostate cancer on Black Men
Among the myriad of cancers, prostate cancer stands out as a particularly ominous threat to Black men.
According to an article by Zero Prostate Cancer, Black and African American men are more likely to develop prostate cancer.
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Studies show that one in six Black men will develop prostate cancer in his lifetime—compared to one in eight men overall.
Furthermore, Black men are 1.7 times more likely to be diagnosed with—and 2.1 times more likely to die from prostate cancer than white men.
Moreover, the Caribbean region has one of the highest age-standardized incidences of prostate cancer globally, with 76 cases per 100,000 population per year, according to a 2022 report by Sage Journals.
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The report states that in Jamaica, 304 men out of 100,000 are diagnosed annually, while in Barbados, the figure stands at 160 men out of 100,000.
Notably, in Tobago, nearly 10 percent of adult men are found to have prostate cancer annually.
Factors impacting a man’s risk
Considering the considerable impact of prostate cancer on Black men, it is essential to recognize that various factors can influence cancer risk and outcomes among Black and African American men.
Zero Prostate Cancer notes that because of historical context, race in the United States is correlated with socioeconomic status, and lower socioeconomic status is correlated with increased cancer risk and worse outcomes.
It also states that Black men may be harmed by racial bias in preventive care.
Furthermore, they are less likely than white men to be offered the option of having a prostate-specific antigen (PSA) test and are more likely than white men to be told that the benefits of the PSA test are uncertain.
The article further highlights a recent study that found that African American men diagnosed with early-stage prostate cancer were less likely than white men to receive any type of treatment for that cancer.
Early detection of prostate cancer
While prostate cancer has impacted many Black men, it is crucial to emphasize that early detection significantly improves treatment outcomes.
The most common screening tool for prostate cancer is the PSA test. This blood test measures the presence of PSA circulating in a man’s bloodstream.
A regular PSA test is one of the tools the doctor will use to measure if the cancer may have returned.
In light of this, health experts advocate for early PSA screening, ideally beginning at age 40, to increase the likelihood of detecting and managing prostate cancer at its earliest stages.
Breast cancer affecting Black women
Similar to Black men, Black women also face high cancer risks, with breast cancer being a prominent concern.
While white women are generally more likely to develop breast cancer, Black women have higher mortality rates from the disease, according to the CDC.
This stems from a combination of factors, including later-stage diagnoses and the aggressive nature of breast cancer in African American women.
Empowering Black women with knowledge about their bodies and encouraging proactive discussions with healthcare providers is paramount in combating this issue.
Higher mortality rates among Black women
Regarding breast cancer in the Caribbean, there is a higher mortality rate in contrast to the United States.
United Nations in the Caribbean reveals that in 2020 alone, there were over 210,000 new diagnoses of breast cancer in Latin America and the Caribbean, resulting in nearly 68,000 deaths.
It further notes that the Americas contributed to almost a quarter of new breast cancer cases in 2020. In Latin America and the Caribbean, women under the age of 50 accounted for 32 per cent of these new cases.
As it related to the United States, a 2024 study by the Breast Cancer Research Foundation (BCRF), reveals that despite a substantial 42 per cent decrease in breast cancer fatalities over the last three decades due to heightened awareness, earlier detection, and enhanced therapies, a significant mortality divide remains between Black women and white women.
The study further states that while breast cancer incidence rates among Black and white women are close, mortality rates are different, with Black women having a 40 per cent higher death rate from breast cancer.
It adds that among women under 50, the disparity is greater. While young women have a higher incidence of aggressive cancers, young Black women have double the mortality rate of young white women.
It further notes that while advances in early detection and treatment have significantly decreased breast cancer mortality rates overall, these advancements have not equally benefited all demographics—and this gap has persisted unchanged for over a decade.
Factors contributing to disparities
BCRF states that the gap in breast cancer incidence and outcome among Black women is complex and multifactorial.
Social, economic, geographic, and lifestyle factors may partially account for disparities.
Studies also reveal that Black women are statistically more likely to have diabetes, heart disease, and obesity, and are less likely to breastfeed after childbirth—all of which are risk factors for breast cancer.
They are more likely than white women to have inadequate health insurance or access to healthcare facilities, which may affect screening, follow-up care, and completion of therapy.
Black women diagnosed at younger ages
BCRF states that Black women are disproportionately affected by more aggressive subtypes, such as triple-negative breast cancer (TNBC) and inflammatory breast cancer, and they are more likely to be diagnosed at younger ages and more advanced stages of the disease.
Health experts suggest that many Black women may benefit from earlier and annual screenings, especially those with a family history of breast or ovarian cancer in a parent, sibling, or child.
Women at a higher risk due to family history are advised to start screening at age 40 or even earlier.
Empowering change through prevention and early detection
Despite the grim statistics, hope persists in the prevention and early detection of cancers impacting Black people. Lifestyle modifications, early detection, and regular screenings are pivotal in detecting cancer at its nascent stages when treatment is most effective.
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