Lack of health care and proper examination of the cancer at the early stage. Is it racial or situational?
From: Cancer Defeated <custserv@cancerdefeated.com>
Date: Wed, Jun 6, 2012 at 5:02 PM
Subject: This group's cancer risk will double
| Newsletter #193 Lee Euler, Editor |
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The President's Cancer Panel report cited three primary reasons for soaring cancer rates among minorities:
- They're disproportionately affected by certain cancers,
- They're often diagnosed at later stages of disease, and
- They frequently have lower survival rates.
How important is it to address cancer risk by ethnicity? Well, recent population projections show that minorities, who currently make up one-third of the U.S. population, are expected to become the collective majority before the middle of the century!
Let's take a look at just two examples of how ethnicity impacts cancer risk...
Let's take a look at just two examples of how ethnicity impacts cancer risk...
Breast and prostate cancer are tough
on non-white Americans
on non-white Americans
According to the National Cancer Institute (NCI), white, non-Hispanic women have the highest incidence for breast cancer among all racial groups in the U.S.
But among women aged 40-50, black women actually have a higher incidence of breast cancer than white women. And black women also have the highest death rate from breast cancer.
Why the disparity? For one thing, NCI said the higher death rate may be linked to how advanced the cancer is at the time of diagnosis.
Given that non-Hispanic whites are at greater overall risk of breast cancer but at lower risk of death from that cancer, the problem appears to be one of detection and treatment, rather than actual risk of getting the disease. Studies show that black women often seek treatment when their cancer has advanced to a less treatable stage.
The President's Cancer Panel says a higher percentage of black Americans and Hispanics lack sufficient health care.
Having a primary care provider increases your chances for receiving the type of routine check-ups and screenings that can detect disorders at an early stage.
So is it all about early detection? More on that in a moment.
Meanwhile, you'll notice similar findings if you examine the rates for prostate cancer...
But among women aged 40-50, black women actually have a higher incidence of breast cancer than white women. And black women also have the highest death rate from breast cancer.
Why the disparity? For one thing, NCI said the higher death rate may be linked to how advanced the cancer is at the time of diagnosis.
Given that non-Hispanic whites are at greater overall risk of breast cancer but at lower risk of death from that cancer, the problem appears to be one of detection and treatment, rather than actual risk of getting the disease. Studies show that black women often seek treatment when their cancer has advanced to a less treatable stage.
The President's Cancer Panel says a higher percentage of black Americans and Hispanics lack sufficient health care.
Having a primary care provider increases your chances for receiving the type of routine check-ups and screenings that can detect disorders at an early stage.
So is it all about early detection? More on that in a moment.
Meanwhile, you'll notice similar findings if you examine the rates for prostate cancer...
Some groups are more likely to die of prostate cancer
According to WebMD, about one man in six will face a prostate cancer diagnosis during his lifetime. But the odds for survival are better than for breast cancer. Only one man in 36 actually dies from the disease.
So which ethnic group is most likely to contain that unfortunate guy?
The answer can be found in the Centers for Disease Control and Prevention (CDC) statistics for annual prostate cancer incidence among 100,000 men during the years 1999-2008.
The results—which are grouped by race and ethnicity—reveal that black men had the highest rate for prostate cancer.
But — somewhat contradicting the theory that being non-white puts you at greater risk -- white men had the second highest rate of getting prostate cancer — higher than Hispanic men as well as men from an Asian/Pacific Islander or American Indian/Alaska Native background.
No one fully understands the reasons for these racial differences. But some experts say they could be linked to environmental factors such as high-fat diets, exposure to heavy metals such as cadmium, infectious agents, or smoking.
One thing for certain is that predictions surrounding future mortality rates for all ethnic groups are troubling…
Dr. LaSalle D. Lefall, Jr., a professor of surgery at Howard University and Margaret Kripke, PhD, a professor at University of Texas' M.D. Anderson Cancer Center are the principal members of the President's Cancer Panel.
In the panel's report, America's Demographic and Cultural Transformation: Implications for Cancer, Lefall and Kripke express concern about how hard it is to determine the impact the increases in non-white cancer rates will have on overall cancer incidence and mortality. They said this is mainly due to limits imposed by current data collection efforts.
So which ethnic group is most likely to contain that unfortunate guy?
The answer can be found in the Centers for Disease Control and Prevention (CDC) statistics for annual prostate cancer incidence among 100,000 men during the years 1999-2008.
The results—which are grouped by race and ethnicity—reveal that black men had the highest rate for prostate cancer.
But — somewhat contradicting the theory that being non-white puts you at greater risk -- white men had the second highest rate of getting prostate cancer — higher than Hispanic men as well as men from an Asian/Pacific Islander or American Indian/Alaska Native background.
No one fully understands the reasons for these racial differences. But some experts say they could be linked to environmental factors such as high-fat diets, exposure to heavy metals such as cadmium, infectious agents, or smoking.
One thing for certain is that predictions surrounding future mortality rates for all ethnic groups are troubling…
Dr. LaSalle D. Lefall, Jr., a professor of surgery at Howard University and Margaret Kripke, PhD, a professor at University of Texas' M.D. Anderson Cancer Center are the principal members of the President's Cancer Panel.
In the panel's report, America's Demographic and Cultural Transformation: Implications for Cancer, Lefall and Kripke express concern about how hard it is to determine the impact the increases in non-white cancer rates will have on overall cancer incidence and mortality. They said this is mainly due to limits imposed by current data collection efforts.
The numbers don't lie... or DO THEY?
Current statistics on cancer incidence are based mainly on social definitions of race and ethnicity. The report says it's well known that these numbers are imprecise because they focus primarily on non-Hispanic white populations.
Lefall and Kripke contend that risk factors, screening guidelines, and treatment regimens identified for one population are not necessarily appropriate for an increasingly diverse population of Americans who are not of European descent.
This also means that the medical and scientific communities have a limited understanding of exactly how key factors influence a person's risk of getting cancer.
And because of this limited understanding—the nation is sorely lacking in medical assistance to help reduce the number of Americans with cancer.
Lefall and Kripke contend that risk factors, screening guidelines, and treatment regimens identified for one population are not necessarily appropriate for an increasingly diverse population of Americans who are not of European descent.
This also means that the medical and scientific communities have a limited understanding of exactly how key factors influence a person's risk of getting cancer.
And because of this limited understanding—the nation is sorely lacking in medical assistance to help reduce the number of Americans with cancer.
A call to action
Researchers will continue to dig for answers about why minority groups are disproportionately impacted by some cancers.
In the meantime, the President's Cancer Panel recommends specific things that should be done to improve cancer care for a changing national demographic.
For example, the panel recommends:
In the meantime, the President's Cancer Panel recommends specific things that should be done to improve cancer care for a changing national demographic.
For example, the panel recommends:
- Teaching students about culture differences in medical school and other healthcare training curricula
- Conducting more research on genetic ancestry and how specific genes influence cancer risk
- Evaluating cancer screening guidelines to determine if they're accurate when it comes to assessing disease risk in members of different ethnic groups
The President's Cancer Panel recognizes the need for "effective cancer education and services across the cancer continuum that reach beyond traditional ideas of race, ethnicity, and culture."
We can only hope that the government and medical establishment will press for pursuit of such goals that could help reduce the burden of cancer for all Americans.
We can only hope that the government and medical establishment will press for pursuit of such goals that could help reduce the burden of cancer for all Americans.
But. . .don't wait for Big Medicine to solve your problems
No doubt non-Hispanic whites — and higher income people in general — get more mammograms, more PSA tests, more prostate and breast biopsies and more "touch" exams of the breast and prostate.
Readers of this newsletter know that all this screening is a mixed blessing. Mammograms are inaccurate and the annual mega-dose of radiation actually increases a woman's risk of cancer. PSA exams are next to worthless. Both tests lead to multiple unnecessary and damaging biopsies and — especially in the case of prostate — unneeded surgeries for unthreatening tumors that might be best left alone.
My guess is that other ethnic and income groups might benefit from more screening while the white and affluent would almost surely benefit from less. It's a difficult question.
I don't believe in one-size-fits-all social answers to questions that are essentially personal and individual. The best you can do is be as informed as you can about your options and take an active role in your own health rather than wait for someone in Washington to order up a test or procedure for you.
Easy to say, I know, for someone like myself who's educated and a compulsive reader. But I simply don't have a better answer. In a couple of hours on our website, a person who can read at a 9th grade level can garner as much information as he or she needs to make a better cancer decision than the "experts" are likely to make for you. So that's what I recommend.
Readers of this newsletter know that all this screening is a mixed blessing. Mammograms are inaccurate and the annual mega-dose of radiation actually increases a woman's risk of cancer. PSA exams are next to worthless. Both tests lead to multiple unnecessary and damaging biopsies and — especially in the case of prostate — unneeded surgeries for unthreatening tumors that might be best left alone.
My guess is that other ethnic and income groups might benefit from more screening while the white and affluent would almost surely benefit from less. It's a difficult question.
I don't believe in one-size-fits-all social answers to questions that are essentially personal and individual. The best you can do is be as informed as you can about your options and take an active role in your own health rather than wait for someone in Washington to order up a test or procedure for you.
Easy to say, I know, for someone like myself who's educated and a compulsive reader. But I simply don't have a better answer. In a couple of hours on our website, a person who can read at a 9th grade level can garner as much information as he or she needs to make a better cancer decision than the "experts" are likely to make for you. So that's what I recommend.
Kindest regards,
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Lee Euler Publisher
Lee Euler Publisher
Resources:
CancerWise. 2012, April. Race and ethnicity as cancer risk factors. Available online at
http://www2.mdanderson.org/cancerwise/2010/04/race-and-ethnicity-as-cancer-risk-factors.html
Centers for Disease Control and Prevention. 2012. Prostate cancer rates by race and ethnicity. Available online at
http://www.cdc.gov/cancer/prostate/statistics/race.htm
Lefall, L.D. and Kripke, M.L. 2011. America's demographic and cultural transformation: Implications for cancer. National Institutes of Health. Report available at
http://deainfo.nci.nih.gov/advisory/pcp/annualReports/pcp09-10rpt/pcp09-10rpt.pdf
WebMD. 2009. Race, ethnicity, and breast cancer risk: Does race or ethnicity affect breast cancer risk? Retrieved online at
http://www.webmd.com/breast-cancer/guide/race-ethnicity-risk
http://www2.mdanderson.org/cancerwise/2010/04/race-and-ethnicity-as-cancer-risk-factors.html
Centers for Disease Control and Prevention. 2012. Prostate cancer rates by race and ethnicity. Available online at
http://www.cdc.gov/cancer/prostate/statistics/race.htm
Lefall, L.D. and Kripke, M.L. 2011. America's demographic and cultural transformation: Implications for cancer. National Institutes of Health. Report available at
http://deainfo.nci.nih.gov/advisory/pcp/annualReports/pcp09-10rpt/pcp09-10rpt.pdf
WebMD. 2009. Race, ethnicity, and breast cancer risk: Does race or ethnicity affect breast cancer risk? Retrieved online at
http://www.webmd.com/breast-cancer/guide/race-ethnicity-risk
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