Recently by David Wetter Ph.D

African-Americans die of cancer at much higher rates than any other racial or ethnic group in the United States. Cancer's toll on African-Americans is particularly high for cancers of the lung, colon and rectum, female breast, prostate and cervix.

The American Cancer Society estimates that about 152,900 new cancer cases will be diagnosed and 62,780 cancer deaths will occur among African-Americans annually. In Texas, African-Americans' cancer mortality rates are 38% higher for men and 22% higher for women, compared to non-Hispanic Whites.

The reasons behind African-Americans' higher rates of cancer occurrence and death are still largely unknown. Large cancer prevention studies, which can help identify specific risks for different populations, often have very low participation from minority communities. This limits the ability of researchers to understand whether the risks that are found for the entire population are the same for specific groups, such as African-Americans.

To reduce the burden of cancer in the African-American community, researchers and the community need to join forces to conduct focused research and to promote activities that will reduce cancer risks. Effective cancer prevention activities for African-Americans need to take into account not just their social situation and the environment they live in, but also their life priorities and concerns.

The African-American Cancer Prevention Project (AACPP) is a collaborative study between the Department of Health Disparities Research and Windsor Village United Methodist Church in Houston, home to the largest African-American Methodist congregation in the United States. This type of study, known as a cohort study, follows healthy individuals over time to see how behavioral, social and environmental factors (such as weight management, cigarette smoking, cancer screening, health care, work and financial issues, neighborhood environment and mental health), contribute to cancer risk for African-Americans.

To date, 1,500 individuals have been enrolled in the study and they will be followed for three years, receiving periodic health assessments, as well as programs and services designed to address concerns such as stress, smoking, and exercise and fitness. Participants also receive help to navigate health and cancer screening and treatment services.  

Open and continuous communications, a lengthy history of community support and the full backing of church leaders have enabled the study to successfully reach its recruiting goals on time. Information gathered from the study will help to increase our understanding and ability to assess cancer risks in African-Americans, as well as identify areas that both M. D. Anderson and the community can focus on to reduce the burden of cancer for African-Americans.

Other Resources
Minorities and Health Disparities (CDC)

African American Health (MedlinePlus)

New research by Ben Smith, M.D., adjunct assistant professor in M. D. Anderson's Department of Radiation Oncology, has proven true Yogi Berra's assertion that, "The future ain't what it used to be!"

Taking into account who's growing old in the United States and how many of us will be old by 2030, Smith projects a 45% increase in cancer diagnosis in general and a 99% increase in cancer incidence among minorities (compared with a 31% increase for non-minorities).

It's very important to note that the researchers aren't saying that anyone's risk for cancer will increase. In fact, their estimates hold the risk to be exactly the same as it is today. Rather, what they're saying is that the number of cancer cases will increase simply because the U.S. population is aging (and older people are more likely to get cancer), and because the proportion of minorities in the U.S. is increasing (so they will make up a bigger percent of the cancer cases in 2030 than they do now).

Among minority groups, expected increases in cancer incidence are:

• 64% for African-Americans
• 76% for American Indian/Alaska natives
• 132% for Asian/Pacific Islanders
• 142% for Hispanics

Currently, although minorities often have higher risk for some cancers, the actual number of minorities who have cancer is low because minorities as a group are younger than the white population and younger people are less likely to get cancer. However, the large group of middle-aged minorities today will make up the group of "old" people in the year 2030. At that time, minority populations will experience the double burden of higher cancer risk and older age. The result will look like an epidemic of cancer in this population. 

Why is this information important for researchers like me and dedicated, caring folks like you? Having a glimpse of the future means that we have time to put into place actions today that can significantly impact the rate of cancer, as well as deaths from cancer, for specific population groups. For example, because minorities are more affected by cancers of infectious origins such as liver cancer and cervical cancer, by implementing effective prevention, education and screening strategies today, we may be able to limit the cancer burden in this group in 2030.

Smith suggests vaccination programs for hepatitis B and human papilloma virus, chemoprevention with tamoxifen and raloxifene, social interventions such as tobacco and alcohol cessation that work for minority groups, and removing pre-cancerous polyps in the colon.

Finally, increasing minorities' participation in cancer clinical trials today will reap even more benefits for care in the future. It will help us to better understand the impact of race on how tissues respond to cancer treatment, the biology of cancer in different groups and effectiveness of cancer therapy for these groups.

One of the fun things about being a clinical psychologist is that when I tell strangers my profession, they typically have one of two reactions: they start backing away under the belief that I can read their minds or they immediately start telling me all sorts of personal information that they'll later regret sharing.

On top of that, I usually get a very puzzled look when I tell them that while I truly can read their minds (just kidding), my work involves studying cancer health disparities. And that almost always requires a definition of health disparities, a description of the causes, who it affects and strategies for reducing it.

So, here's the 30-second overview.
Health disparities refer to differences in health status and health outcomes among different groups. These differences can result from genetics, environmental factors, access to care and cultural factors. For example:

It's important to note that health disparities affect more than just racial/ethnic minorities. Other groups that experience health disparities include the poor, rural residents, individuals with low literacy and many other groups.
Our goal in the Department of Health Disparities Research is to reduce and ultimately eliminate disparities in cancer incidence, morbidity and mortality through research and education. Some examples of our research include:

  • How to help low-income pregnant women who smoke quit and stay that way
  • How to reduce barriers to participating on a breast cancer trial for minority women
  • How migrant farm workers' exposure to pesticides affects not only their genes and risks for cancers, but their children's genes and risks as well 
Of course, no research would be possible without people willing to participate in research. Our programs partner with community organizations to increase awareness and understanding among underserved populations of the role of research and clinical trials in cancer prevention and treatment.
Fortunately, our work is attracting more and more interest. We're hoping that we get to the point, as quickly as possible, where I don't have to do any introduction to the topic of health disparities, except as a history lesson.


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