Racial Disparities in Cancer
- Dr. Anita Johnson spoke with SurvivorNet in an exclusive interview on the racial disparities in cancer care.
- Dr. Johnson emphasizes the need for greater healthcare access and screening access, particularly for African American women.
- Closing the racial disparity gap in cancer care and treatment is a longstanding issue that can no longer be ignored!
- American Indian and Alaska Native people have the highest overall cancer rates and death rates, especially among women.
- Black men have the highest cancer rates of any sex–race group. Between 2018 and 2022, their cancer incidence was 78% higher than that of American Indian and Alaska Native men, who had the lowest rates.
- Asian American, Native Hawaiian, and Pacific Islander (AANHPI) men are the only group where men have lower cancer rates than women.
WATCH: Working Together To Reduce Racial Disparities
Where the Biggest Mortality Gaps Appear
- American Indian and Alaska Native people have the highest death rates for several cancers, including kidney, liver, stomach, and cervical cancer, about twice as high as White people.
- Black men face extremely high prostate cancer mortality—two to four times higher than all other men.
- Black women have the highest death rates from both breast cancer and uterine cancer, with uterine cancer deaths twice as high as in other women.
- Hispanic and AANHPI communities have a lower risk for many common cancers, but they experience 30%–50% higher liver cancer deaths and double the stomach cancer deaths compared with White people.
- Within the AANHPI category, Pacific Islander people face even more severe disparities, such as three-times higher stomach cancer mortality, and two and a half times higher uterine and cervical cancer mortality compared with White women.
- Overall, cancer mortality is twice as high among Asian Americans as among women and 50% higher among men.
Why these disparities persist
Read MoreHow Does This Show Up In a Diagnosis
Black women are more likely to be diagnosed at later stages:- Only 56% of uterine cancers and 58% of breast cancers are caught early in Black women
- Compared with 71% and 69% in White women
One study found that simply ensuring Black patients receive the same quality colorectal cancer screening as White patients could reduce deaths by 19%—eliminating two‑thirds of the racial gap in colorectal cancer mortality.
WATCH: A Long-Standing Hurdle: Gaining the Trust of Communities of Color
In an exclusive interview with SurvivorNet, Dr. Anita Johnson pinpoints critical points where action is needed to help close the racial gaps in cancer care.
We asked Dr. Johnson what accounts for the big racial disparity in survival rates and basic cancer care; lack of screenings is high on her list. "I'm here in Atlanta," she says, "where we have some of the highest death rates from breast cancer in the country. And so when we look at different metropolitan areas, particularly Memphis, Atlanta, Los Angeles, Houston, Chicago, where there are more black women, but still they're not being screened adequately," this is an ongoing problem. Proper screenings and access to healthcare (and insurance) are critical components to close the gap.
Dr. Johnson is the chief of surgery at Cancer Treatment Centers of America in Atlanta. As a graduate of Morehouse School of Medicine, a historically black college, she has a greater awareness of where the disparities lie and what we can do about them.
Close the Gap
Cancer treatment disparities are a grim fact of life in America. Cancer survival rates for Black cancer patients are lower than that of their white counterparts, and that must change. SurvivorNet is committed to being part of the change and raising awareness around this gap in care.
The SurvivorNet "Close the Gap" initiative is committed to improving the survival rates of all people diagnosed with cancer, regardless of their background. Our partners in this initiative include NYU Langone and The Perlmutter Cancer Center. We are committed to the fight for equality.
Historical Disparities in Cancer Care
The fight for equality is something Dr. Johnson cares deeply about, and she emphasizes that this is a historical issue. She tells SurvivorNet, “When we look at the literature concerning health disparities, particularly in African Americans, we know that when it comes to the death rates, their numbers are extremely high. And in the 1990s, about 30% of African Americans who were diagnosed with any type of cancer actually passed away from cancer.” Progress has been made, thankfully, in the past decades, but there is still much work to be done.
“We’re in the teens [percentage-wise] now,” says Dr. Johnson, “but when we look at the presentation of say, is an African American woman being diagnosed with breast cancer. It’s oftentimes you’re diagnosed at a much later stage and, as well as, at a much earlier age. So when it comes to certain patient populations, particularly African Americans, um, there are disparities in breast cancer, colon cancer, prostate cancer, and even lung cancer.”
Current Disparities in Care
Dr. Johnson points specifically to breast cancer as an example in the difference in mortality rates. “When it comes to breast cancer,” she tells SurvivorNet, “the mortality rates for African American women are substantially higher than Caucasian women. They [African American women] often present with triple-negative breast cancer, which is a more aggressive type of breast cancer, which always requires chemotherapy and has a higher recurrence rate.”
Related: Close the Gap: Racial Disparities in Cancer Care Are Devastating Let's Change Things
“When we look at stage four,” Dr. Johnson says, “the outcomes are much worse as compared to Caucasian women. When we look at the standard of care treatment options based on stages, in some cases, African American women are not being treated with the same standard of care treatment options.”
Ways to Eliminate Racial Disparities in Cancer Care
Screenings are an avenue to decrease the gap, says Dr. Johnson. “We cannot wait till the age of 45 or 50 to start screening mammograms for African American women; a significant portion of them present [with cancer] at a much earlier age, younger than 45 years old,” she explains to SurvivorNet.
Related: The Different Stages of Cancer & What It Means for You
In addition to earlier, more frequent screenings, Dr. Johnson says there are other ways to close that gap:
- Reviewing a patient’s family medical history
- Increased access to clinical trials
- Greater overall access to healthcare
- More access to oncologists
While there are opportunities for closing the gap, there is still much work to be done and it is urgent work emphasizes Dr. Johnson. “This is an emergency; it’s not new it’s been going on for several decades. So when we’re looking at solutions, education is key, clinical trials is key. Access to care is key. But what also is important is that we actually provide an environment where patients can access care.
Access is important, but Dr. Johnson isn’t just implying physical access. “When we talk about access, it’s not just the distance from your home to a facility; it’s [also] actually having insurance companies assist us with screening patients in an appropriate time and age. And so when we’re waiting to screen, you know, some of our African American [patients], sometimes it’s just too late. And that’s where we need some policies to be changed.”
Moving Forward Together
Closing the gap is the responsibility of all, not just the medical community and insurance companies. It rests on the shoulders of all of us to speak up, in large and small ways, and to advocate that all people be treated equally when it comes to healthcare and in every other matter of life.
Black Women Die From Breast Cancer at Shockingly Higher Rates Than White Women
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