Diverse Disparities Affect Cancer Mortality Risk - EMJ

Racial, Socioeconomic, and Geographic Disparities Affect Cancer Mortality Risk

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AN UPDATED report from the American Cancer Society (ACS) revealed that individuals with a lower socioeconomic status, populations living in non-metropolitan areas, and Black and American Indian/Alaska Native (AIAN) individuals bear a disproportionately higher burden of cancer-related deaths.

The 2023 report provided an update on racial, ethnic, socioeconomic (using educational attainment as a marker), and geographic (metropolitan status) disparities in cancer occurrence and outcomes. The authors also reviewed programmes that have reduced cancer disparities, and provided new policy recommendations to bridge these inequalities.

The data showed that, compared to individuals living in large metropolitan areas, those living in non-metropolitan areas had a higher rate of mortality from all cancers and leading causes of cancer deaths. For instance, mortality rates from colorectal cancer were 23% higher among males, and 21% higher among females. Disparities within geographic status were more pronounced among younger populations (≤65 years of age). Furthermore, overall cancer mortality rates were 18–19% higher among Black and AIAN males, compared to White males, and 12–16% higher among Black and AIAN females, compared to White females, despite a 7–9% lower cancer incidence rate among Black and AIAN females.

Disparities by educational attainment were even larger than racial disparities in overall cancer mortality, with 60–180% higher rates among individuals with ≤12 years of education, compared to those with ≥16 years of education. The authors suggested a major role for socioeconomic disparities in racial disparities in cancer mortality, given the disproportionally larger representation of Black people in lower socioeconomic status groups.

“Many of the observed racial, socioeconomic, and geographic disparities in cancer mortality align with disparities in exposure to risk factors and access to cancer prevention, early detection, and treatment, which are largely rooted in fundamental inequities in social determinants of health,” stated Ahmedin Jemal, Senior Vice President of the Department of Surveillance and Health Equity Science at ACS. Jemal emphasised that equitable policies at all levels of government, broad interdisciplinary engagement, and equitable implementation of evidence-based policies will be required to mitigate these disparities.

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