Cancer Disparities

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<ul class="usa-sidenav__sublist"> <li class="usa-sidenav__item"> <a href="/about-cancer/understanding/what-is-cancer" data-menu-id="910891">What Is Cancer?</a> </li> <li class="usa-sidenav__item"> <a href="/about-cancer/understanding/statistics" data-menu-id="923365">Cancer Statistics</a> </li> <li class="usa-sidenav__item"> <a href="/about-cancer/understanding/disparities" data-menu-id="1058013" class="usa-current" aria-current="page">Cancer Disparities</a> </li> </ul> </li> </ul> </nav> </div> <div class="cgdpl desktop:grid-col-9"> <div id="content" class=""> <main class="contentzone has-section-nav" id="main-content"> <div data-drupal-messages-fallback class="hidden"></div>  <article> <div class="resize-content"> <h1> Cancer Disparities </h1> <div id="cgvBody"> <div data-entity-embed-display="view_mode:media.image_display_article_medium" class="embedded-entity align-right"> <figure class="image-medium centered-set"> <div class="centered-element"> <img loading="lazy" src="/sites/g/files/xnrzdm211/files/styles/cgov_article/public/cgov_image/media_image/2020-11/social-network-scheme.jpg?h=4b0d5422&itok=2UgJSJ6Q" width="970" height="555" alt="Collage of people icons" /> </div> <figcaption> <div class="caption-container no-resize"> <p>Although cancer incidence and mortality overall are declining in the United States, certain groups continue to be at greater risk of developing or dying from particular cancers.</p> <div class="image-photo-credit">Credit: iStock</div> </div> </figcaption> </figure> </div> <p style="margin-bottom:11px">Cancer affects all population groups in the United States, but due to social, environmental, and economic disadvantages, certain groups bear a disproportionate burden of cancer compared with other groups.</p> <p>Cancer disparities (sometimes called cancer health disparities) are differences in cancer measures such as:</p> <ul> <li>incidence (new cases)</li> <li>prevalence (all existing cases)</li> <li>mortality (deaths)</li> <li>survival (how long people survive after diagnosis)</li> <li>morbidity (cancer-related health complications)</li> <li>survivorship (including quality of life after cancer treatment)</li> <li><a data-entity-substitution="canonical" data-entity-type="node" data-entity-uuid="a106ebfc-e832-4dd5-88ff-396b5b710071" href="/about-cancer/managing-care/track-care-costs/financial-toxicity-pdq">financial burden of cancer</a> or related health conditions</li> <li>screening rates</li> <li>stage at diagnosis</li> </ul> <p>Cancer disparities can also be seen when outcomes are improving overall but the improvements are not seen in some groups relative to other groups.</p> <p>Population groups that may experience cancer disparities include groups defined by race, ethnicity, disability, gender identity, geographic location, income, education, age, sexual orientation, national origin, and other characteristics.</p> <div class="accordion" data-otp-selector> <section id="contributing-factors"> <h2>Examples of Cancer Disparities</h2> <p>Although cancer incidence and mortality overall are declining in all population groups in the United States, some groups continue to be at increased risk of developing or dying from certain cancers.</p> <div data-embed-button="cgov_featured_content_button" data-entity-embed-display="view_mode:node.embedded_feature_card" data-entity-type="node" data-entity-uuid="0d988fc9-f4ec-4a88-a8e3-72383a91eb83" data-langcode="en" data-entity-embed-display-settings="[]" class="embedded-entity align-right"> <div class="feature-card"> <a href="/news-events/cancer-currents-blog/2024/cancer-disparities-social-drivers"> <div class="image-hover"> <img loading="lazy" src="/sites/g/files/xnrzdm211/files/styles/cgov_featured/public/cgov_image/media_image/2024-03/massey%20van%203.JPG?h=c5e84e41&itok=pPpEaLd7" width="425" height="319" alt="A brightly decorated van with a health care working speaking to several people from the van's side door."> </div> <h3>Putting Cancer Disparities in the Rearview Mirror</h3> <p>Tackling cancer disparities will require advances and changes that go well beyond the laboratory and doctor’s office.</p> </a> </div> </div> <p>Statistics from NCI’s <a href="https://seer.cancer.gov/">Surveillance, Epidemiology, and End Results Program</a> include information specific to racial and ethnic groups as well as populations defined by age, gender, and geography. Some key cancer incidence and mortality disparities in the United States include:</p> <ul> <li>Black/African American people have higher death rates than all other racial/ethnic groups for many, although not all, cancer types.</li> <li>Despite having slightly lower incidence rates of <a data-entity-substitution="canonical" data-entity-type="node" data-entity-uuid="2f6e6fda-233f-497a-a8d5-02018e8821c6" href="/types/breast">breast cancer</a> than those of White women, Black/African American women are more likely than White women to die of the disease.</li> <li>The incidence rates of <a data-entity-substitution="canonical" data-entity-type="node" data-entity-uuid="60ec4af0-59be-4c4e-8a61-9277d72dc74b" href="/types/colorectal">colorectal</a>, <a data-entity-substitution="canonical" data-entity-type="node" data-entity-uuid="3139a3d9-c3a1-448d-a9e2-51489861951a" href="/types/lung">lung</a>, and <a data-entity-substitution="canonical" data-entity-type="node" data-entity-uuid="41131663-d23d-45ce-ad33-1e325923d4c8" href="/types/cervical">cervical cancers</a> are much higher in people who live in rural Appalachia than in those who live in urban areas in the region.</li> <li>Although deaths from <a data-entity-substitution="canonical" data-entity-type="node" data-entity-uuid="00270a09-f049-4fbe-b7a5-f4bd3f740847" href="/types/prostate">prostate cancer</a> have dropped substantially in recent decades among all men, Black/African American men are more than twice as likely as White men to die of prostate cancer and continue to have the highest prostate cancer mortality rates among all US racial/ethnic groups.</li> <li>People with more education are less likely to die prematurely (before the age of 65) from colorectal cancer than those with less education, regardless of race or ethnicity.</li> <li>Hispanic/Latino, Black/African American, and American Indian/Alaska Native women have higher incidence rates of cervical cancer than women of other racial/ethnic groups, with Black/African American women having the highest rates of death from the disease.</li> <li>American Indians/Alaska Natives have higher death rates from <a data-entity-substitution="canonical" data-entity-type="node" data-entity-uuid="22e69599-aaa8-42ed-96e6-50892feb7761" href="/types/kidney">kidney cancer</a> than any other racial/ethnic group.</li> <li>The rates of <a href="https://www.cdc.gov/mmwr/volumes/67/wr/mm6732a4.htm">smoking and alcohol drinking, which increase cancer risk, are higher among lesbian, gay, and bisexual youths</a> than among heterosexual youths.</li> <li>American Indians/Alaska Natives have the highest incidence and mortality rates of <a data-entity-substitution="canonical" data-entity-type="node" data-entity-uuid="33fa5be3-7100-4912-a798-c12cd1c74799" href="/types/liver">liver and intrahepatic bile duct cancer</a>, followed by Hispanics/Latinos and Asians/Pacific Islanders.</li> </ul> <h2>Contributing Factors</h2> <div class="callout-box-right"> <h3>Social Determinants of Health</h3> The Department of Health and Human Services defines <a href="https://health.gov/healthypeople/objectives-and-data/social-determinants-health">social determinants of health</a> as the conditions in the environments where people are born, live, learn, work, play, worship, and age that affect health, functioning, and quality of life.</div> <p>Cancer disparities reflect the interplay among many factors, including social determinants of health, behavior, biology, and genetics—all of which can have profound effects on health, including cancer risk and outcomes.</p> <p>Certain groups in the United States experience cancer disparities because they are more likely to encounter obstacles in getting health care.</p> <p>For example, people with <a data-entity-substitution="canonical" data-entity-type="node" data-entity-uuid="9a96c6b8-c5d9-4b4b-b644-2320d74655cb" href="/news-events/cancer-currents-blog/2020/persistent-poverty-increased-cancer-death-risk">low incomes</a>, low <a href="https://health.gov/our-work/healthy-people-2030/about-healthy-people-2030/health-literacy-healthy-people">health literacy</a>, or long travel distances to screening or treatment sites, or who lack health insurance, transportation to a medical facility, or paid medical leave are less likely to have recommended cancer screening tests and to be treated according to guidelines than those who don’t encounter these obstacles.</p> <p>People who do not have reliable access to health care are also more likely to be diagnosed with late-stage cancer that might have been treated more effectively if it had been diagnosed at an earlier stage.</p> <p>Some groups are disproportionately affected by cancer due to environmental conditions. People who live in communities that lack clean water or air may be exposed to <a data-entity-substitution="canonical" data-entity-type="node" data-entity-uuid="ac012a94-44ae-4b5b-ba30-27d056ba9a84" href="/about-cancer/causes-prevention/risk/substances">cancer-causing substances</a>.</p> <p>The <a href="https://health.gov/healthypeople/objectives-and-data/browse-objectives/neighborhood-and-built-environment">built environment</a> can also influence behaviors that raise one’s risk of cancer. For example, people who live in neighborhoods that lack affordable healthy foods or safe areas for exercise are more likely to have <a data-entity-substitution="canonical" data-entity-type="node" data-entity-uuid="0d598040-a643-428b-ac47-dcaeeff1b29c" href="/about-cancer/causes-prevention/risk/diet">poor diets</a>, <a data-entity-substitution="canonical" data-entity-type="node" data-entity-uuid="4d217bfc-4cdf-4355-95a9-6afb39704404" href="/about-cancer/causes-prevention/risk/obesity/physical-activity-fact-sheet">be physically inactive</a>, and <a data-entity-substitution="canonical" data-entity-type="node" data-entity-uuid="383d4cea-45b6-419d-8a30-b655a4b1de51" href="/about-cancer/causes-prevention/risk/obesity">obese</a>, all of which are risk factors for cancer.</p> <p>Even people of higher socioeconomic status and those with health insurance may experience cancer disparities. The disparities these individuals experience may reflect the health impact of institutional racism and the chronic stress it causes, conscious or unconscious bias from health providers, mistrust of the health care system, or fatalistic attitudes about cancer.</p> <p>In some cases, inherited factors or tumor biological factors may, either directly or by interacting with factors such as diet, chronic stress, or tobacco exposure, lead to cancer disparities.</p> <div class="callout-box-right"> <h3>Health Equity</h3> According to the Centers for Disease Control and Prevention, <a href="https://www.cdc.gov/chronicdisease/healthequity/index.htm">health equity</a> is achieved when every person has the opportunity to attain his or her full health potential and no one is disadvantaged from achieving this potential because of social position or other socially determined circumstances. <div data-embed-button="cgov_image_button" data-entity-embed-display="view_mode:media.image_display_article_full" data-entity-embed-display-settings="[]" data-entity-type="media" data-entity-uuid="979f9ad5-4b9f-45f5-b23b-ea5e1d6f96e5" data-langcode="en" class="embedded-entity"> <figure class="image-full centered-set"> <div class="centered-element"> <img loading="lazy" src="/sites/g/files/xnrzdm211/files/styles/cgov_article/public/cgov_image/media_image/2020-11/health-equity.jpg?h=7bf6b2c9&itok=lsgQS0Cu" width="970" height="808" alt> </div> <figcaption> <div class="caption-container no-resize"> <div class="image-photo-credit">Credit: iStock</div> </div> </figcaption> </figure> </div> </div> <p>For example, some evidence suggests that there are differences in the genetics, tumor biology, and immune environment of several cancers that arise in Black/African Americans compared with those that arise in people of other racial/ethnic groups. These differences may contribute to disparities in incidence, cancer growth rate, and response to treatment of these cancers.</p> <p>Cancer disparities may also be exacerbated by the lack of diversity in <a class="definition" data-glossary-id="CDR0000774488" href="/Common/PopUps/popDefinition.aspx?id=CDR0000774488&version=Patient&language=en">clinical research</a> participation. Because of this lack of diversity, research results may not be applicable to all populations.</p> <p>Because many different factors can influence cancer disparities, addressing them is not simple or straightforward. Reducing or eliminating some cancer disparities in the pursuit of health equity will require policy changes to overcome systemic social, racial, and institutional inequalities.</p> <p>NCI-funded researchers are working to identify other ways to improve outcomes for groups disproportionately affected by cancer. Their research efforts range from designing and implementing culturally appropriate health interventions, to improving access to care and <a data-entity-substitution="canonical" data-entity-type="node" data-entity-uuid="e5e6f889-e8fd-47e9-8d3e-50f2975782e1" href="/about-nci/organization/cche/community-outreach/cusp2ct">connecting underrepresented populations to clinical trials</a>, to examining biological and genetic factors that may explain differences in rates of fast-growing cancers.</p> <p>Learn about <a data-entity-substitution="canonical" data-entity-type="node" data-entity-uuid="23242ed7-c377-4d62-a2f0-aba4a2172f3f" href="/research/areas/disparities">cancer health disparities research</a> and <a data-entity-substitution="canonical" data-entity-type="node" data-entity-uuid="16dc292d-a8a7-4d41-b114-86573cb5a33d" href="/research/key-initiatives/nci-equity-inclusion-program">NCI’s efforts to end structural racism in biomedical research</a>.</p> </section> </div> </div> </div> <footer class="article-footer"> <div id="nvcgRelatedResourcesArea"> <div> <aside class="related-resources list"> <h2 class="related-resources__heading">Related Resources</h2> <ul> <li class="general-list-item general list-item title-only"> <div class="title-and-desc title desc container"> <a class="title" href="https://seer.cancer.gov/statfacts/html/disparities.html">Cancer Stat Facts: Cancer Disparities</a> </div> </li> <li class="general-list-item general list-item title-only"> <div class="title-and-desc title desc container"> <a class="title" href="/about-nci/organization/cche">NCI Center to Reduce Cancer Health Disparities (CRCHD)</a> </div> </li> <li class="general-list-item general list-item title-only"> <div class="title-and-desc title desc container"> <a class="title" href="/research/areas/disparities">Cancer Disparities Research</a> </div> </li> <li class="general-list-item general list-item title-only"> <div class="title-and-desc title desc container"> <a class="title" href="http://surveillance.cancer.gov/statistics/types/race_ethnic.html">Finding Statistics by Race/Ethnicity</a> </div> </li> <li class="general-list-item general list-item title-only"> <div class="title-and-desc title desc container"> <a class="title" href="https://www.cancer.gov/news-events/cancer-currents-blog?topic=disparities">Disparities—Cancer Currents Blog</a> </div> </li> </ul> </aside> </div> </div> <div class="document-dates horizontal"> <ul class="clearfix"> <li> <strong>Updated:</strong> <time datetime="2024-03-21T12:00:00Z">March 21, 2024</time> </li> </ul> </div> <div id="nvcgSlPublicUse"> <div class="slot-item only-SI"> <div class="public-use"> <div id="block-ncids-trans-public-use"> <p><em>If you would like to reproduce some or all of this content, see <a href="/policies/copyright-reuse">Reuse of NCI Information</a> for guidance about copyright and permissions. 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