Cancer death rates in the United States have decreased dramatically over the past 35 years, with a 35% reduction, according to a report from the American Association for Cancer Research released Wednesday.
This decline, which translates to nearly 5 million fewer cancer deaths since 1991, has been largely due to increased screening and advances in cancer treatments.
However, this progress has not been seen uniformly across the country.
“African American communities and American Indian and Alaska Native populations have the highest overall cancer mortality rates of any racial/ethnic group in the United States, which means higher incidence and mortality for multiple types of cancer,” said report coordinator Mariana Stern, professor of Clinical Population Sciences and Public Health and of Urology at the Keck School of Medicine of the University of Southern California.
Increased screening has helped prevent 79% of colorectal cancer deaths, according to the AACR report. During a colonoscopy, doctors remove precancerous polyps before they have a chance to turn into cancer. People at average risk are recommended to start screening at age 45.
However, the report found that screening rates are lower among non-white populations.
(Only 46% of men with a mental illness receive treatment. See when to ask for help)
In 2023, only 53% of Hispanic people and 57% of Asian and American Indian/Alaska Native people were up to date on their colonoscopies, compared to 67% of white people.
The Hispanic population has seen the largest increase in early-onset colorectal cancer, with annual increases of 4.7% among women and 3.7% among men.
Alex Valdez, 40, was diagnosed with colorectal cancer when he was 38 years old. He had undergone a colonoscopy to monitor his ulcerative colitis and Crohn’s disease.
“When the pathology results came back, they told me I had a 7-centimeter tumor on the other side of my colon and that I had probably had cancer for a year and a half or two without even knowing it,” Valdez said. “Many people have the misconception that you don’t need to have a colonoscopy until your mid-40s, but it happened to me when I was 38.”
Experts say screening is crucial to reducing the overall burden of cancer by detecting the disease at an earlier stage, when it is easier to treat. However, inequalities continue to exist in access to these services.
(Study reveals that sugary drinks in children can cause risk of hypertension in adulthood)
Furthermore, cervical cancer detection rates were consistently lowest among Asian and Hispanic womencompared to white women, according to the report. Women in poor counties are also less likely to undergo regular screening for this type of cancer.
Black people in the United States have long had higher cancer death rates than white people, although the gap has narrowed in recent years.
Still, black people are about twice as likely to die from multiple myeloma and cancers of the stomach, prostate and gallbladder as white people. In the case of breast cancer, mortality rates are 35% higher among black women than among white women.
Colorectal cancer – the incidence of which is increasing in people under 50 years of age – also has higher mortality rates among African American and American Indian/Alaska Native populations compared to white populations.
“Cervical cancer is still a problem,” said Dr. Sarah Kim, a gynecologic surgeon at Memorial Sloan Kettering Cancer Center in New York City. “Especially for patients who don’t have access to health care for a multitude of reasons, one of which is actually that these are people who are socially disadvantaged or maybe they have multiple jobs or they don’t have good health insurance and therefore they can’t visit their gynecologist once a year.”
(A doctor warns that parents should talk to a doctor before their children take a GLP-1)
The report found that cervical cancer rates were 32% higher among women living in poor counties, compared to higher-income counties. Death rates from this type of cancer are 49% higher in poor counties.
The findings are particularly striking given that cervical cancer It can be prevented with the HPV vaccine.
“This is one of those vaccines that we know has no side effects, really only benefits, and prevents women from developing cervical cancer,” Kim said. “There is no prescription needed, no doctor’s appointment needed, you can just go to your CVS, Walgreens or Duane Reade, order the HPV vaccine and the pharmacist will give it to you.”
Disparities in cancer diagnoses and mortality rates are due to a variety of factors that can be difficult to disentangle, including the persistent effects of systemic racism and the social, economic, and physical conditions in which people live and that influence their health and quality of life. These factors affect not only detection and diagnosis, but also treatment.
According to the report, patients from racial and ethnic minority groups, as well as low-income populations and others with limited access to medical services, are less likely to receive care recommended for your type of cancer, despite important advances in cancer treatment.
Finding the time and resources to receive adequate care is also a challenge. Many Americans say they can’t afford health care, and enrollment in Medicaid and the Affordable Care Act has dropped by more than 5 million over the past year, according to a report by the advocacy group Protect Our Care.
Stern noted that in many hospitals there are resources available to help patients in their current situation and guide them through their cancer treatment, which has proven to be very successful.
“An example that has been used in multiple studies and has been shown to be very effective (…) is the use of patient navigators,” Stern said.
Patient navigators work with people to overcome barriers to accessing care and guide them through the health system. Kim said he worked closely with patient navigators during his medical residency.
“We called (patients) and made sure they kept their appointments, because that’s really the most important thing when it comes to cervical cancer: do not miss follow-up appointments”.
However, future funding for these programs is uncertain.
“The current Government has proposed cutting the NIH budget (National Institute of Health) and eliminate the National Institute on Minorities and Health Disparities, (which) suggests that there could be some threats to our progress in eliminating cancer disparities,” Stern stressed.
