Can Ethnicity and Race Impact Cancer Survival?

A cancer diagnosis is scary for everyone. For many of us, it’s our worst fear. Clearly, we worry about the prognosis and the potentially hard treatments that lay ahead. What we shouldn’t have to worry about is how our race or ethnicity could impact our chance of having a positive outcome. But it looks fairly certain that it does. And not always in a positive way. How and why does ethnicity and race impact cancer survival rates?

Researchers analyzed the diagnoses, treatments and outcomes of 950,377 Asian, Black, White, and Hispanic patients. Each patient had received a diagnosis of prostate, ovarian, breast, stomach, pancreatic, lung, liver, esophageal, or colorectal cancer between January 2004 and December 2010. The team analyzed at least 5 years’ worth of data for each patient. The results, as seen below, indicate it’s likely that ethnicity and race impact cancer survival.

* Metastatic cancer – the spread of cancer cells from the place where they first formed to another part of the body.

** Definitive treatment – the plan chosen as the best one for a patient after all other choices have been considered.

The nitty gritty – how race impacts cancer survival rates.

This study is unique in that it analyzed the cancer stage at diagnosis, treatment, and survival for each patient. The study identified many areas in which ethnicity and race impact cancer survival rates. Among the study’s findings:

• White patients were more likely than Asian patients to develop metastasis in stomach, lung, liver and colorectal cancers.
• Black patients were more likely to have metastatic prostate, ovarian, breast, and colorectal cancers than Asian patients.
• Asian patients with gastric cancer have better survival rates than patients from other racial/ethnic groups.
• White patients with lung cancer had worse survival rates than Asian patients.
• White patients were more likely to develop metastatic liver cancer, less likely to receive active treatment, and more likely to have worse outcomes than Asian patients.
• The Asian patients with colorectal cancer had the best survival outcomes compared with other groups.
• White patients with prostate cancer had higher rates mortality than Asian patients.
• Compared with Asian patients, white patients received more treatments for ovarian cancer and had the best prognoses for breast cancer. In contrast, Black patients received treatment less often and had worse outcomes.

Further findings demonstrate a slight improvement in racial disparities.

A 2020 report by AACR (American Association for Cancer Research) cites a reduction in the racial disparities for cancer death rates. In 1990, the cancer death rate for Blacks was 33% higher than the rate for whites. But in 2016, the difference declined to 14%. Even better news, the disparity in the overall cancer death rate between Blacks and whites is close to zero for men under the age of 50 and for women 70 and older.

What causes differences in cancer survival among different ethnicities and races?

Experts believe the differences in survival rates among different races and ethnicities are likely caused by many factors, including tobacco or alcohol use, diet (too much fat and red meat), obesity and/or a genetic susceptibility to cancer.

Additionally, access to high-quality health care can vary between ethnic and racial groups, with shortages of doctors and medical centers in communities of color. Clearly, access to cancer screening can lead to earlier detections of cancer and improve survival rates. Furthermore, access to “definitive” care treatments, the plan chosen as the best one for a patient after all other choices have been considered, can improve survival rates.

Research shows that the socioeconomic status, health insurance coverage, and access to medical care for Blacks in the US tends to be lower than other racial/ethnic groups, which can lead to worse cancer outcomes. For instance, colorectal screenings for Black patients lags behind other groups. Moreover, Blacks are more likely to have an aggressive form of colorectal cancer, which leads to lower survival rates for Black patients with colorectal cancers than for those in other racial/ethnic groups.

Given these factors, it’s easy to understand how ethnicity and race impact cancer survival rates.

What can you do about the impact of ethnicity and race on cancer survival?

The chances of surviving cancer increase with early detection.

First, stay on top of your healthcare and screenings. Use the cancer screening guidelines published by the US Centers for Disease Control and Prevention to learn about the recommended frequency of tests, along with a description of each test. However, realize recommendations can change as scientific research evolves. You can also find helpful information on cancer screening on the National Cancer Institute site.

It’s also important to talk to you doctor about your risk factors for cancer. Ask if your race, ethnicity, gender, age, work, eating, drinking, smoking, drug use or other habits put you at increased risk for cancer. Certainly, being honest about your lifestyle with your doctor, and yourself, is important. Ask what steps you can take to reduce your risk of cancer. And of course, ask your doctor about cancer screenings.

Is money keeping you from cancer screenings?

If you have private insurance offered through your employer, your coverage probably includes free cancer screenings for mammograms, colonoscopies, and other tests, with no co-pay or deductible. However, it’s always a good idea to call your insurance company to learn about costs before scheduling an appointment.

Medicare coverage? Watch out – it can be complicated.

Medicare provides free screening for many cancers, but coverage varies. To learn about coverage requirements for screenings, including for breast, cervical, lung, prostate and colorectal cancers, visit the Medicare.gov site.  Importantly, realize your doctor may recommend screenings more often than the Medicare payment schedule allows. Or, your doctor may recommend services that Medicare doesn’t cover. In these situations, you may have to pay some or all of the costs. So before scheduling any screening test, ask your doctor:

• Why he/she is recommending each test.
• If Medicare will pay for each test, given your circumstances.
• How much you can expect to pay.

According to the Medicare website, the amount you’ll owe can depend on several things, including:

• Other insurance you may have.
• How much your doctor charges.
• Whether your doctor accepts the assignment. (Assignment means that your doctor, provider, or supplier agrees to, or is required by law, to accept the Medicare-approved amount as full payment for covered services.)
• Where you get your test, item, or service.

No insurance coverage at all?

If you don’t have health insurance, you might be able to get low-cost or free cancer screenings. Call the National Cancer Institute (1-800-422-6237) or the American Cancer Society (1-800-227-2345) for help.