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Cancer Disparities in Minority Groups

Cancer Disparities in Minority Groups
It’s estimated that in 2020, the United States had 1,806,590 newly diagnosed cancer cases. However, these cases are not spread evenly throughout the country. While cancer can affect anyone, cancer health disparities are seen throughout minority groups, who receive the most fatal diagnoses each year.  Cancer disparities are common across all types of cancer, but as breast cancer is the most common cancer in the United States, we see the highest breast cancer racial disparity among patients.  Aside from breast cancer, the most common cancers in the United States today are:   
  • Pancreatic cancer
  • Thyroid cancer
  • Liver cancer
  • Colon or rectum cancer
  • Lung Cancer
  • Prostate cancer
  • Skin melanoma
  • Bladder cancer
  • Non-Hodgkin lymphoma
  • Leukemia
  In this article, we discuss cancer disparities in the United States as they relate to minority groups. We’ll discuss cancer in the BIPOC and LGBTQ population, why these groups are most heavily affected by cancer, and how we can work towards ending this disparity. 

The BIPOC Population

In 2019, The American Cancer Society released a report on cancer facts and figures. This report found that Black men are 22% more likely to die from cancer than white men. Black women are 13% more likely to die than white women. The good news is that cancer survival rates in the African American population have improved. From 1960 to 1963, cancer survival rates in the Black population were approximately 27%. From 2008 to 2014, this increased to approximately 62%. In comparison, cancer survival rates for white Americans from 2008 to 2014 is 67%.  Breast cancer rates are also a telling demonstration of cancer disparity among the BIPOC community. Breast cancer mortality rates in the United States are 41% higher in Black women than white women.  For Indigenous peoples in the United States, this disparity exists as well. From 2012 to 2016, studies showed that American Indians and Alaska Natives were approximately twice as likely to develop liver or colon cancer than white Americans. This is also true of Asian and Pacific Islander natives American Indians and Alaska Natives have the highest rates of kidney cancer, and Alaska Natives have the country’s highest colorectal cancer rates. And this is just a snapshot of statistics concerning cancer disparities among the BIPOC population in the United States.

The LGBTQ Population

There is concern that the LGBTQ population also has disproportionately high rates of cancer. This is especially true of prostate cancer in gay and bisexual men. The issue is that there are currently not enough studies to know disparity rates. The same may be true for trans women; however, there are not enough statistics on this at the moment.  The lack of available data on the LGBTQ cancer disparity rates highlights yet another disparity and raises concern for some medical professionals and communities.  The same issues come with assessing rates of breast cancer and other cancers in lesbian and queer women. Some research does exist, but sample sizes of studies have been too small to produce conclusive results.  The LGBTQ community is at risk because we have little to no information about this group’s at-risk cancers. Transgender and gender-nonconforming people are largely marginalized in scientific research. There are no studies that have assessed whether their cancer rates are higher. 

What Causes Cancer Disparities in Minority Groups

Multiple factors cause cancer disparities in minority groups. Of course, genetics can play a part in cancer risk.  However, genetics do not account for the significantly higher mortality rate from cancer in some minority groups than in white people. To explain this inequality, let’s look at how socioeconomic status and health literacy factor into cancer disparities. 

Socioeconomic Status Levels for Black Americans

The same 2019 American Cancer Society report cited earlier also examined socioeconomic status. It found that people with lower socioeconomic statuses died of cancer more often than those with high statuses. This was regardless of race and ethnicity.  However, there are significantly more BIPOC Americans living below the poverty line than white Americans. A survey by the American Psychology Association found that while 14% of white children and teens live below the poverty line:   
  • 39% of African-American children and teens live in poverty
  • 33% of Latino children and teens live in poverty
  • African American unemployment rates are double unemployment rates for Caucasians
  • African Americans make approximately 72% of Caucasians working similar roles
  Minority groups are also more likely to experience intergenerational poverty, which can cause long-term trauma and make employment and affordable wages more difficult to attain. 

Socioeconomic Status Levels for LGBTQ Americans

In a  2017 NPR survey, 31% of transgender Americans were found to lack health insurance. Furthermore, hormone therapies, gender affirmation surgeries, and other medical procedures relevant to the LGBTQ community are not covered by health care.  This leaves transgender people requiring these procedures and prescriptions left paying out-of-pocket, putting a low-income bracket of people at even more of a socioeconomic disadvantage.  Studies show that people in the LGBTQ community often have lower incomes and are more dissatisfied with their living standards than people who do not identify as LGBTQ. The same study reveals that in the United States, there are many barriers to affordable health care for LGBTQ people and families.  These barriers include inequities due to marriage laws. Often, health care plans do not recognize and cover domestic partners, which causes a lack of medical coverage for domestic partners in states where gay marriage is not legal. 

Socioeconomic Status and Cancer Rates

So what is the link between socioeconomic status and cancer?  When individuals can’t afford to get tested and screened for cancer, they can’t identify precancerous signs and prevent more severe diagnoses.  For example, due to advances in medicine and early detection practices, 90% of cervical cancer patients recover. However, if a person cannot afford a medical visit for cervical cancer screening, their chances of survival are lower.  In a study of health insurance coverage for American adults 18 to 64 years old, research showed that Blacks and Hispanics are significantly less likely to have health care coverage under their employer than whites. And Black and Hispanic people are less likely to have a primary care doctor and more likely to receive treatment in an emergency room.  A 2017 study found that lower-income women were less likely to receive biopsies, radiation, and other breast cancer treatments commonly given to middle-class or above-middle-class women. This applies to low-income LGBTQ folks, who are unable to access health care through their significant other, or who live below the poverty line.  While minority groups remain disadvantaged by socioeconomic status, they will also lack early cancer screenings, early diagnosis, and many treatment options. This continues to contribute to cancer disparities in minority groups.  

Low Health Literacy

Health literacy is the ability to access and understand health information.  A 2019 study assessed health literacy in groups of people. Participants with the highest health literacy were white women aged 18 to 34 with an income less than or equal to $200,000 a year and a post-baccalaureate education level.  The ability to access and understand health information is hugely important to cancer disparities. Understanding lifestyle choices that can pose a significant risk for cancer and understanding the importance of regular cancer screenings can vastly reduce cancer risks.  Because higher education is often inaccessible to low-income groups, and minorities make up the majority of low-income groups, minorities are disproportionately affected by low health literacy. On top of this, the United States healthcare system’s complexities require advanced knowledge and high health literacy to navigate, making medical help even more challenging to access.  A study revealed that African Americans are disproportionately affected by low health literacy due to systemic and historic inequities in the United States. The same study showed that African Americans and other minority groups are more likely to distrust healthcare providers because of documented poor and unjust treatment of minority groups by the healthcare system.  The same information is not available about LGBTQ groups, but the correlation between socioeconomic status and health literacy reveals the cancer inequalities LGBTQ people experience living in the United States. 

Cancer Disparities Prevention

Recognizing these disparities exist is the first step towards closing the gap. Many BIPOC and LGBTQ folks feel uncomfortable visiting medical professionals due to discrimination. Many more simply can’t afford access to these services.  Furthermore, many doctors are unaware of these biases and the health-specific needs of some minority groups. For example, a 2017 study assessed doctors’ knowledge of LGBTQ-specific health needs. More than half of the doctors surveyed knew little about the cancer types prevalent amongst LGBTQ people and the health-specific needs of LGBTQ people.  For individuals, knowing how to recognize early warning signs that something is wrong is an excellent way to increase your health literacy and keep yourself safe. Monitoring moles for any changes that could be indicative of skin cancer or melanoma is essential. And women can conduct breast self-exams at home. Please be advised that screening yourself for cancer at home is not sufficient for early cancer detection. A medical check-up is the only way to ensure early detection.  To truly prevent cancer disparities among minority groups, we need to address socioeconomic inequality and biases within the medical community. 

Tackling Cancer Disparities

For too long, cancer disparities have continued to exist in the United States. BIPOC and LGBTQ people have continued to be more at risk for later-stage diagnoses and death from cancer. In recent years, activists have been working to expose and address these inequities.  By shedding light on these issues and acknowledging this disparity, CityHealth hopes to actively address cancer disparities in minority groups. CityHealth is the Bay Area’s leading patient-centered healthcare clinic. If you need cancer screening, have other health-related concerns, or simply need a check-up, contact CityHealth. We have two locations in San Leandro and Oakland to serve you. If you can’t come in for an appointment, we offer virtual consultations for some health concerns.  CityHealth has a transparent pricing policy, whether you are paying out-of-pocket or you have insurance coverage. If you have further questions about billing, we’re here to help at (510) 984-2489.  If you’re ready to come in, book an appointment online in San Leandro or Oakland.
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