Cancer Disparities Toolkit
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Incidence
Based on SEER 2014-2018 cancer data, incidence rates for males diagnosed with CRC are highest in African American males (49.9 per 100,000 persons).
Incidence rates for women diagnosed with CRC are highest in African American women (37.5 per 100,000 persons).
The Non-Hispanic Black population has the highest rates of advanced distant-stage CRC and the lowest 5-year survival of all race and ethnicities.
Incidence rates for young-onset CRC African Americans having been growing; this population tend to be diagnosed with tumors in the proximal colon which tends to have higher mortality rates and poor outcomes. A call to action to change screening strategies by changing the age of when people get screened.6 The screening age was changed to age 45 based on recommendations by American Cancer Society to save more lives.
Prevalence
Prevalence of proximal adenoma is higher in Blacks than whites even though the total prevalence and prevalence for ages <60 were the same by race.
Mortality
Mortality rates for CRC are highest in African American males (22.5 per 100,000 persons) and African American females (14.8 per 100,000 persons).
Disparities among African Americans with mortality rates are attributed by less screening and stage-specific survival rates.
Data Trends
African Americans tend to face barriers to gain access to early detection via screening, quality diagnostic, and treatment interventions.
Prevalence
Screening prevalence among Hispanics is 50%.
Mortality
Colorectal cancer is the 3rd cause of cancer mortality in the Hispanic population.
Incidence
Lower CRC screening rates and lack of insurance coverage have been contributors to slower declines of CRC incidence rates for Hispanics.
Incidence
Incidence rates for women diagnosed with CRC are highest in American Indian/Alaska Native women (37.5 per 100,000 persons).
Lower SES American Indian/Alaskan Natives have an increased risk of distant-stage CRC diagnosis compared to lower SES whites.
Data Trends
American Indian/Native Americans tend to face barriers to gain access to early detection via screening, quality diagnostic, and treatment interventions.
“Among insurance status groups, cases with no insurance experienced the highest proportions of distant-stage diagnosis (53.7%), followed by those with Medicaid (50.6%), and both were associated with higher risks of distant-stage diagnoses compared with other categories of insurance.”
Other Factors
Asian/Pacific Islanders tend to face barriers to gain access to early detection via screening, quality diagnostic, and treatment interventions.
Other Factors
Lack of adequate training, communication, and cultural humility in health care providers contribute to the disparities that the LGBTQ+ community faces.
Other Factors
CRC screenings have not reached American Indian/Alaska Native, low socioeconomic groups, and those with mental illness or substance abuse.
Access to Care
Barriers to screenings include lack of health insurance, low income or worry about cost, lack of access to mammography centers, cultural and language differences, etc.
Incidence
Incidence rates for non-Hispanic Blacks is 126.7 per 100,000 persons.
Even though non-Hispanic whites have the highest incidence rates out of all races/ethnicities (130.8 per 100,000 people), non-Hispanic Blacks have the highest incidence rates before age 40.
Prevalence
The high prevalence of obesity, dietary patterns, and lack of physical activity has been correlated with an increase in breast cancer risks, and non-Hispanic Blacks are disproportionately impacted by these factors.
Mortality
Non-Hispanic Black women have the highest mortality rates (28.4 per 100,000 persons) among all races/ethnicities. This is more than double the rate of Asian/Pacific Islander women (11.5 per 100,000 persons).
Black women aged 50 and younger are 1.9-2.6 times more likely to die from breast cancer than white women.
Data Trends
For every stage at diagnosis, Black women have the lowest breast cancer survival rate.
The triple-negative breast cancer subtype is the least favorable type of breast cancer, and it is more common in Black women aged 50 or younger. (Triple-negative breast cancer indicates the estrogen receptor-negative (ER-negative), progesterone receptor-negative (PR-negative), and hormone epidermal growth factor receptor 2 negative (HER2-negative) subtypes)
Systemic Factors
Black people are underrepresented in clinical trials because they only comprise less than 10% which hinders the generalizability of trials’ findings.
Non-Hispanic Blacks are getting mammograms more than any race/ethnic group at 74%, but their mortality rates are highest among all races. (Non-Hispanic white = 73%, Hispanic & Non-Hispanic Asian = 71%, American Indian/Alaska Native = 66%).
Other Factors
Some findings have shown Black and African American women may have more delays in follow-up after an abnormal mammogram than white women.
Access to Care
Barriers to screenings include lack of health insurance, low income or worry about cost, lack of access to mammography centers, cultural and language differences, etc.
Prevalence
In 2018, the prevalence of up-to-date mammography was lower in Hispanics (55%-60%) than non-Hispanic Blacks (65%), non-Hispanic whites (64%), and American Indian/Alaska Natives (64%).
The high prevalence of obesity, dietary patterns, and lack of physical activity has been correlated with an increase in breast cancer risks, and Hispanics are disproportionately impacted by these factors.
Access to Care
Barriers to screenings include lack of health insurance, low income or worry about cost, lack of access to mammography centers, cultural and language differences, etc.
Prevalence
In 2018, the prevalence of up-to-date mammography was lower in Asians (55%-60%) than non-Hispanic Blacks (65%), non-Hispanic whites (64%), and American Indian/Alaska Natives (64%).
Data Trends
There has been a relatively steady increase in incidence rates based on race/ethnicity; incidence rates increased the most in Asian/Pacific Islander (1.5% per year), followed by American Indian/Alaskan Natives (0.8% per year), and non-Hispanic Blacks and whites (0.5% per year); the rates were stable among Hispanics.
Access to Care
Barriers to screenings include lack of health insurance, low income or worry about cost, lack of access to mammography centers, cultural and language differences, etc.
Other Factors
American Indian/Alaskan Natives tend to struggle with access of care and utilization of cancer screening services.
Access to Care
Barriers to screenings include lack of health insurance, low income or worry about cost, lack of access to mammography centers, cultural and language differences, etc.
Access to Care
Barriers to screenings include lack of health insurance, low income or worry about cost, lack of access to mammography centers, cultural and language differences, etc.
Data Trends
“Higher rates of lung cancer among Blacks occur even though they have lower smoking rates, smoke fewer cigarettes per day, and are less likely to be heavy smokers, compared to Whites.”
Environmental Factors
“Lung cancer in non-smokers is almost exclusively non-small cell lung cancer, with adenocarcinoma being the most common type. Non-smoking women are more likely to get lung cancer than non-smoking men.”
Prevalence
“Non-Hispanic blacks are more likely to live in counties that had worse problems with particle pollution, researchers found in a 2011 analysis.”
Non-Hispanic Blacks are disproportionately impacted by lung cancer compared to non-Hispanic whites despite have lower smoking prevalence.
Mortality
African American men have the highest mortality rate among all racial/ethnicity group.
Relative survival rates among Blacks are 52% when diagnosed in at the localized stage, but early detection only happens with 16% of diagnoses due to the lack of symptoms.
The 5-year relative survival rate for NH Blacks are 16% compared to NH whites which is 19%.
Incidence
African Americans/Black men have the highest incidence rate (71.2/100,000 persons) compared to other racial/ethnic groups.
The Black and Native Hawaiian population have the highest incidence rates of lung cancer, while the Hispanic and Asian population have the lowest incidence rates.
Systemic Factors
In July 2020, the US Preventive Services Task Force (USPSTF) recommended lowering the initial age for screening from 55 to 50 and lowered smoking history from 30 pack-years to 20 pack-years.These criterions also reflect the Centers of Medicare and Medicaid Services (CMS) and can further cause disparities for populations to be ineligible for screening.
People on Medicaid (25.5%) and uninsured (24%) are over twice the rate to smoke than those with private insurance (11.1%).
Psychosocial Factors
Individuals with mental illness experienced an increase in lung cancer due to higher smoking prevalence and reduction in cancer screenings.
Environmental Factors
“Lung cancer in non-smokers is almost exclusively non-small cell lung cancer, with adenocarcinoma being the most common type. Non-smoking women are more likely to get lung cancer than non-smoking men.”
Prevalence
"Hispanics are more likely to live in counties that had worse problems with particle pollution, researchers found in a 2011 analysis."
Systemic Factors
In July 2020, the US Preventive Services Task Force (USPSTF) recommended lowering the initial age for screening from 55 to 50 and lowered smoking history from 30 pack-years to 20 pack-years. These criterions also reflect the Centers of Medicare and Medicaid Services (CMS) and can further cause disparities for populations to be ineligible for screening.
People on Medicaid (25.5%) and uninsured (24%) are over twice the rate to smoke than those with private insurance (11.1%).
Psychosocial Factors
Individuals with mental illness experienced an increase in lung cancer due to higher smoking prevalence and reduction in cancer screenings.
Mortality
Lung cancer is the leading cause of cancer death in Hispanic men, and the 2nd leading cause of cancer death in Hispanic women.
Environmental Factors
“Lung cancer in non-smokers is almost exclusively non-small cell lung cancer, with adenocarcinoma being the most common type. Non-smoking women are more likely to get lung cancer than non-smoking men.”
Systemic Factors
In July 2020, the US Preventive Services Task Force (USPSTF) recommended lowering the initial age for screening from 55 to 50 and lowered smoking history from 30 pack-years to 20 pack-years. These criterions also reflect the Centers of Medicare and Medicaid Services (CMS) and can further cause disparities for populations to be ineligible for screening.
People on Medicaid (25.5%) and uninsured (24%) are over twice the rate to smoke than those with private insurance (11.1%).
Psychosocial Factors
Individuals with mental illness experienced an increase in lung cancer due to higher smoking prevalence and reduction in cancer screenings.
Environmental Factors
“Lung cancer in non-smokers is almost exclusively non-small cell lung cancer, with adenocarcinoma being the most common type. Non-smoking women are more likely to get lung cancer than non-smoking men.”
Systemic Factors
People on Medicaid (25.5%) and uninsured (24%) are over twice the rate to smoke than those with private insurance (11.1%).
Environmental Factors
“Lung cancer in non-smokers is almost exclusively non-small cell lung cancer, with adenocarcinoma being the most common type. Non-smoking women are more likely to get lung cancer than non-smoking men.”
Systemic Factors
In July 2020, the US Preventive Services Task Force (USPSTF) recommended lowering the initial age for screening from 55 to 50 and lowered smoking history from 30 pack-years to 20 pack-years. These criterions also reflect the Centers of Medicare and Medicaid Services (CMS) and can further cause disparities for populations to be ineligible for screening.
People on Medicaid (25.5%) and uninsured (24%) are over twice the rate to smoke than those with private insurance (11.1%).
Psychosocial Factors
Individuals with mental illness experienced an increase in lung cancer due to higher smoking prevalence and reduction in cancer screenings.
Prevalence
Compared to the general population, military service members are 25% more likely to receive a lung cancer diagnosis.
Environmental Factors
“Lung cancer in non-smokers is almost exclusively non-small cell lung cancer, with adenocarcinoma being the most common type. Non-smoking women are more likely to get lung cancer than non-smoking men.”
Systemic Factors
In July 2020, the US Preventive Services Task Force (USPSTF) recommended lowering the initial age for screening from 55 to 50 and lowered smoking history from 30 pack-years to 20 pack-years. These criterions also reflect the Centers of Medicare and Medicaid Services (CMS) and can further cause disparities for populations to be ineligible for screening.
People on Medicaid (25.5%) and uninsured (24%) are over twice the rate to smoke than those with private insurance (11.1%).
Psychosocial Factors
Individuals with mental illness experienced an increase in lung cancer due to higher smoking prevalence and reduction in cancer screenings.
Data Trends
Smoking is higher in the LGBTQ+ community compared to heterosexual individuals; bisexuals tend to have the highest smoking rates among subgroups.
Socioeconomic Factors
Socioeconomic risk factors have contributed to an increased risk of cancer and access to PSA testing should be available to younger men.
Data Trends
A study found that Black men diagnosed with early-stage prostate cancer were less likely to receive any type of treatment than white men.
Incidence
African American/Blacks in the US are 1.5 times more likely to develop prostate cancer compared to whites and 3 times more likely compared to Asian Americans.
Based on 2018 CDC data and per 100,000 people, African Americans/Blacks had an incidence rate of 164.4, whites had 98.7, Hispanics had 80.2, Asian and Pacific Islanders had 55.5 and American Indian/Alaskan Native had 47.2
Mortality
African American/Blacks in the US are 2.2 times more likely to die from prostate cancer compared to whites and 4 times more likely compared to Asian Americans.
Other Factors
Blacks are more susceptible to having prostate cancer that is more aggressive and less likely to receive adequate treatment.
More Blacks need to be considered in research studies; changing guidelines may need to be suggested to get earlier screening done this population.
Socioeconomic Factors
Socioeconomic risk factors have contributed to an increased risk of cancer and access to PSA testing should be available to younger men.
Data Trends
“From 2012-2016, Hispanic men were 10 percent less likely to be diagnosed with prostate cancer than non-Hispanic white men.”
Prevalence
The most diagnosed cancer among Hispanic men is prostate cancer.
Socioeconomic Factors
Socioeconomic risk factors have contributed to an increased risk of cancer and access to PSA testing should be available to younger men.
Other Factors
Veterans exposed to herbicides called Agent Orange in the Vietnam and Korean War have an increased risk of developing prostate cancer and more aggressive forms of it.
Socioeconomic Factors
Socioeconomic risk factors have contributed to an increased risk of cancer and access to PSA testing should be available to younger men.
Socioeconomic Factors
Socioeconomic risk factors have contributed to an increased risk of cancer and access to PSA testing should be available to younger men.
Socioeconomic Factors
Socioeconomic risk factors have contributed to an increased risk of cancer and access to PSA testing should be available to younger men.
Incidence
African Americans have twice the risk of developing multiple myeloma compared to white Americans, and they are diagnosed younger than whites too.
African Americans will roughly make up about a quarter of the newly diagnosed multiple myeloma patients in 2034.
According to 2018 CDC data, Blacks have the highest incidence rates of newly diagnosed multiple myeloma with 13.2 per 100,000 people, followed by Hispanics with 6.4 per 100,000 people, and whites with 5.9 per 100,000 people.
Prevalence
The highest prevalence of the multiple myeloma precursor, monoclonal gammopathy of undetermined significance (MGUS), is among Blacks in America.
Mortality
According to 2018 CDC data, Blacks have the highest mortality rates of multiple myeloma with 5.6 per 100,000 people, followed by American Indian and Alaska Native with 3 per 100,000 people, and whites with 2.9 per 100,000 people.
Data Trends
Reports show that African Americans are having early onset of multiple myeloma compared to whites. It is also possible that Hispanics are diagnosed earlier than African Americans as well.
Blacks have lower rates of stem cell transplantation (SCT) treatments compared to whites.
Other Factors
Bringing proper awareness to the Black community about multiple myeloma can help decrease the risk of developing the disease since they are the most impacted by it.
Patients that had Medicare only or Medicaid were significantly less likely to receive novel therapeutic agents of SCT compared with patients with private insurance.
Socioeconomic Factors
People living in rural areas have barriers that prevent them from gaining access to novel therapies, transplant centers, and enrollment clinical trials.
Data Trends
There is suggested evidence that veterans who were exposed to Agent Orange in the Vietnam War have an increased risk of developing multiple myeloma.
Other Factors
Patients that had Medicare only or Medicaid were significantly less likely to receive novel therapeutic agents of SCT compared with patients with private insurance.
Socioeconomic Factors
People living in rural areas have barriers that prevent them from gaining access to novel therapies, transplant centers, and enrollment clinical trials.
Data Trends
Reports show that Hispanics are having early onset of multiple myeloma compared to whites.
Hispanics have lower rates of stem cell transplantation (SCT) treatments compared to whites, but recent studies show that Hispanics may have the lowest rates of the treatment.
Other Factors
Patients that had Medicare only or Medicaid were significantly less likely to receive novel therapeutic agents of SCT compared with patients with private insurance.
Socioeconomic Factors
People living in rural areas have barriers that prevent them from gaining access to novel therapies, transplant centers, and enrollment clinical trials.
Other Factors
Patients that had Medicare only or Medicaid were significantly less likely to receive novel therapeutic agents of SCT compared with patients with private insurance.
Socioeconomic Factors
People living in rural areas have barriers that prevent them from gaining access to novel therapies, transplant centers, and enrollment clinical trials.
Other Factors
Patients that had Medicare only or Medicaid were significantly less likely to receive novel therapeutic agents of SCT compared with patients with private insurance.
Socioeconomic Factors
People living in rural areas have barriers that prevent them from gaining access to novel therapies, transplant centers, and enrollment clinical trials.
Other Factors
Patients that had Medicare only or Medicaid were significantly less likely to receive novel therapeutic agents of SCT compared with patients with private insurance.
Socioeconomic Factors
People living in rural areas have barriers that prevent them from gaining access to novel therapies, transplant centers, and enrollment clinical trials.