Report shows disparities in cancer outcomes based on race, location and sexuality

In the United States, the cancer mortality rate continues to decline, falling by 33% between 1991 and 2020.

However, not all Americans are benefiting from advances in cancer prevention, early detection and treatment, according to a new report from the American Association for Cancer Research (AACR).

According to the 2024 AACR Cancer Disparities Progress Report, race, location, and sexual orientation all play a role in cancer disparities in the United States.

Blacks and Native Americans continue to have the highest cancer mortality rates of all racial and ethnic groups, even though their overall cancer rates are lower than those of whites, the report said.

There are striking differences in cancer death rates, particularly among black Americans:

• Black men are twice as likely to die from prostate cancer as white men.

• Black women have a 40 percent higher risk of dying from breast cancer than white women, even though their cancer rates are similar.

• Black people are twice as likely to develop and die from multiple myeloma, a form of blood cancer.

At the same time, some population groups – American Indians/Alaska Natives, Asians/Pacific Islanders, and Hispanics – are more than twice as likely to die from stomach cancer as whites. These groups also have higher rates of developing and dying from liver cancer.

A person’s zip code also plays a role in their cancer risk, the report says.

Researchers found that people in predominantly rural areas are 38 percent more likely to develop and die from lung cancer than people in urban areas.

Another source of inequality is a person’s sexual and gender orientation, as the report shows:

• The risk of breast cancer is higher in women from sexual minorities than in heterosexual women

• Transgender people have a 76% higher risk of developing advanced lung cancer than cisgender people.

• Transgender women are twice as likely to die from prostate cancer as cisgender men, even though their risk of developing the disease is 60% lower.

“The findings of this report provide a deeper look at the ‘whole person’ in terms of the areas outside of medicine that contribute to health disparities,” said Dr. Robert Winn, chair of the AACR steering committee that prepared the report.

“We have made tremendous progress in the fight against cancer over the past few decades, but we must continue to fight to ensure equitable access and improved health care for all,” added Winn, who is director of the Massey Comprehensive Cancer Center at Virginia Commonwealth University.

According to the report, possible causes for these observed injustices could include:

• Social determinants of health include education level, income, employment, housing, transportation, and access to health care and good food. Residents of disadvantaged neighborhoods have a 22% higher death rate from all cancers combined, the report says.

• Differences in biological factors such as genetics, immune profile and intestinal bacteria

• A lack of cancer genetics research involving a broad ethnic diversity

• Lack of diversity in healthcare and cancer research

However, some progress has been made in reducing these differences, the report added.

The disparity in overall cancer mortality between blacks and whites has narrowed significantly over the past three decades, from 33% in 1990 to just over 11% in 2020.

In particular, differences have decreased in the following areas:

• Lung cancer in white and black men.

• Cervical cancer in white and Hispanic women.

• Stomach cancer in white and Asian/Pacific Islander populations.

The AACR report calls for billions of dollars in federal funding to address these inequities, including more than $51 billion for the National Institutes of Health and nearly $8 billion for the National Cancer Institute in 2025.

The AACR also called for $472 million in funding for a U.S. Centers for Disease Control and Prevention program to promote health equity and continued funding for Cancer Moonshot activities.

“In this era of extraordinary scientific advances in the fight against cancer, it is critical that we ensure no population or community is left behind. Health equity is a fundamental human right and must be a national priority,” said Dr. Margaret Foti, AACR Executive Director.

“We hope that the information and recommendations in this report will stimulate collaboration among stakeholders and garner the necessary congressional support to address these complex issues and eliminate disparities in cancer care once and for all,” Foti added in an AACR press release.

More information

The National Cancer Institute has more information on cancer disparities.

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