From the Guidelines
Black Americans have the highest cancer mortality rates, despite not having the highest overall incidence, with significant disparities in access to healthcare, later-stage diagnoses, and differences in treatment quality contributing to these outcomes. Cancer rates vary among racial and ethnic groups in the United States, with non-Hispanic White Americans generally having the highest overall cancer incidence rates, though this varies by specific cancer type 1. For specific cancers, patterns differ significantly - Black men have the highest rates of prostate cancer, as noted in a 1997 study where the incidence of prostate cancer was found to be 66% higher among African-American men than among white men 1, while White women have the highest rates of breast cancer. Asian Americans typically have lower overall cancer rates. These differences result from complex interactions between genetic factors, environmental exposures, lifestyle behaviors, socioeconomic status, and healthcare access.
- The highest incidence of and mortality from colorectal cancer is found among Black adults, with incidence rates of 43.6 cases per 100,000 and death rates of 18.0 deaths per 100,000, compared to other racial and ethnic groups 1.
- Social determinants of health, including unequal access to healthcare, contribute significantly to disparities in cancer outcomes, with Black residents of the United States experiencing higher colon cancer incidence and mortality than non-Hispanic White patients 1.
- Genetic factors, such as BRCA1 and BRCA2 mutations, also play a role in cancer disparities, with higher frequencies of certain mutations found in African American patients with prostate cancer 1.
- Healthcare access and quality are critical factors in addressing cancer disparities, with targeted approaches recommended for different populations to address varying challenges and limitations 1.
From the Research
Cancer Rates by Race
- The race with the highest rates of cancer is African American/Black individuals, who have a disproportionate cancer burden, including the highest mortality and the lowest survival of any racial/ethnic group for most cancers 2, 3, 4.
- According to a study published in 2022, African American/Black individuals have a 6% higher incidence rate of cancer than White men, but a 19% higher mortality rate 2.
- Another study published in 2019 found that African American/Black individuals have the highest death rate and the lowest survival rate of any racial or ethnic group for most cancers 3.
- A more recent study published in 2023 found that Black men have the highest cancer death rates, followed by White, American Indian/Alaska Native, Native Hawaiian and Pacific Islander, Latino, and Asian men 5.
- Black women also have the highest cancer death rates, followed by Native Hawaiian and Pacific Islander, American Indian/Alaska Native, White, Latina, and Asian women 5.
Comparison of Cancer Rates
- The cancer mortality rate is highest in Black men (298.2 per 100,000) and Black women (206.5 per 100,000) compared to other racial and ethnic groups 5.
- The total cancer death rates are 39% higher in Native Hawaiian and Pacific Islander men and 73% higher in Native Hawaiian and Pacific Islander women compared to Asian individuals 5.
- African American/Black individuals have a 16% higher mortality rate than White men, despite having only a 4% higher incidence rate 4.
- Black women have a 10% higher mortality rate than White women, despite having a 9% lower incidence rate 4.
Factors Contributing to Disparities
- The causes of ongoing disparities in cancer rates are multifactorial, but largely stem from inequalities in the social determinants of health that trace back to structural racism 4.
- Increasing diversity in clinical trials, enhancing provider education, and implementing financial incentives to ensure equitable care across the cancer care continuum may help close these gaps 4.