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By Robin Baumeister

Race accounts for higher mortality rates for all cancer sites, studies find. While this should come as no surprise, its gravity is no less present; regardless of gender, black cancer patients face higher mortality than their white peers.  

Among black men, cancer incidence is also higher; black men have 25% higher incidence than white men for all cancer types combined. And while women do not face higher incidence rates than white women for all cancer types, they do for breast and cervical cancer—some of the most common and devastating cancer sites. Native American, Asian, and Pacific Islander patients face similarly high rates of mortality as compared to non-Hispanic whites. 

The reasons for these disparities are many and multifaceted. For one, minorities are more likely to be medically underserved, implying reduced access to diagnostic tests and lessened quality of treatment. Minorities are also less likely to be involved in clinical trials, which might impact the efficacy of treatment options for minority groups. 

Another less obvious reason for this disparity has also been proposed—racism. The stress associated with racial discrimination can have physiological consequences, including faster disease progression, as a result of higher allostatic load. The stress of racism may also be correlated with the use of behavioral risks as coping mechanisms that in turn may increase cancer incidence and progression. These risks include smoking, alcohol use, and unhealthy eating habits. 

Racism can also affect perceived control and discrimination, which may be barriers to accessing medical diagnoses or treatment options in the first place. One study found that those who faced racial discrimination by police, work, and in housing were 31% more likely to develop breast cancer than those who did not. Whether or not this was the result of stress or behavioral coping strategies, the fact of the matter remains clear: racism can increase breast cancer risk. It is imperative that similar studies are undertaken in order to understand the full picture regarding racial discrimination and cancer incidence/progression.

Especially considering current attention to the racist foundations of American institutions of power, it is critical that racism’s identification as a health issue does not lose traction. Until racism can be overturned in its entirety, it cannot be looked over in the assessment of cancer risk.

 

References

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Haynes, M. A., & Smedley, B. D. (1999). The Burden of Cancer Among Ethnic Minorities and Medically Underserved Populations. In The Unequal Burden of Cancer: An Assessment of NIH Research and Programs for Ethnic Minorities and the Medically Underserved. Washington, DC: National Academies Press (US).

 

Lisovicz, N., Wynn, T., Fouad, M., & Partridge, E. E. (2008). Cancer health disparities: what we have done. The American journal of the medical sciences, 335(4), 254–259. https://doi.org/10.1097/maj.0b013e31816a43ad

 

Ogedegbe, G. (2020). Responsibility of Medical Journals in Addressing Racism in Health Care. JAMA Network Open, 3(8). doi:10.1001/jamanetworkopen.2020.16531

 

Taylor, T. R., Williams, C. D., Makambi, K. H., Mouton, C., Harrell, J. P., Cozier, Y., Palmer, J. R., Rosenberg, L., & Adams-Campbell, L. L. (2007). Racial discrimination and breast cancer incidence in US Black women: the Black Women’s Health Study. American journal of epidemiology, 166(1), 46–54. https://doi.org/10.1093/aje/kwm056

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