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Minorities to Bear Brunt of Rise in U.S. Cancer Cases
Date:4/29/2009

Rate among Hispanics, blacks will double over next 20 years, report warns

WEDNESDAY, April 29 (HealthDay News) -- The United States will see a surge in the number of new cancers over the next two decades, driven by an aging population and an increased proportion of minorities, a new report predicts.

Rates of new cancer diagnosis are expected to jump by 45 percent among the population generally and by 67 percent among people aged 65 or older. New cancer cases are predicted to double among minorities, experts say.

This spike in new cases will sharpen health-care disparities and will outpace population growth, according to a study appearing in the April 29 issue of the Journal of Clinical Oncology and announced Wednesday at a news conference sponsored by the American Society of Clinical Oncology (ASCO).

Minorities will be hit the hardest. "Disparities facing minority patients are now reaching crisis proportions," said Dr. Derek Raghavan, director of the Cleveland Clinic Taussig Cancer Institute and co-chair of ASCO's Health Disparities Advisory Group. "It is critical that we take action to address these disparities before they reach these numbers."

ASCO also released a policy statement on disparities in cancer care, which is "our first step toward reducing these inequalities," Raghavan said. "Even when economic and insurance status is similar, there are still quality gaps in the care minorities receive."

"Decades of research led to the development of sophisticated treatment and screening methods, resulting in a substantial improvement in survival rates. But there is a profound divide between those with access to these improved results and those without access," said ASCO president Richard L. Schilsky, a professor of medicine at the University of Chicago.

"One in five blacks are uninsured," he noted. "More than one in three Latinos, Native Americans and Alaska Natives are uninsured. People lacking health insurance are less likely to survive cancer."

The number of adults aged 65 and over is expected to increase to 72 million by 2030 (from 25 million in 1980). Meanwhile, the number of Americans in a minority group is expected to increase to 157 million in 2030 (up from 46 million in 1980).

The authors of this study used data from a national health database to project rates of future cancer diagnoses.

According to the projections, between 2010 and 2030, total incidence of all cancers will increase by 45 percent, from 1.6 million to 2.3 million, though the total population will increase by only 19 percent.

Cancer incidence is expected to increase 67 percent in the older population vs. 11 percent in the younger age group and to double among minorities, compared with a 31 percent increase among whites.

Hispanics will experience the most dramatic rise in cancer incidence, 142 percent, said study author Dr. Benjamin Smith, chief of radiation oncology at Wilford Hall Medical Center, located at Lackland Air Force Base in San Antonio, Texas. Smith is also adjunct assistant professor in the department of radiation oncology at M.D. Anderson Cancer Center, in Houston.

Cancers with poor outcomes, namely liver, stomach, pancreatic and lung, are expected to be among the fastest-growing cancer types as the population changes.

"These are projections and the absolute numbers may, in fact, be slightly higher than what ends up happening," Raghavan said. "What is absolutely clear is that the trends are very strong and are inescapable.

The authors advocated more screening and implementation of prevention efforts such as vaccinating for the hepatitis B virus (linked to liver cancer) and human papilloma viruses (the main cause of cervical cancer), reducing tobacco and alcohol use and removing polyps in the colon.

ASCO's policy statement vowed to work towards eliminating cancer disparities through increased awareness, better access to care, more oriented research, better recruitment of minorities in clinical trials, more workforce diversity, programs to increase access to care in underserved regions and to underserved populations and better coverage for people living with cancer.

"We have known for a long time that we would have an emerging group of aging baby boomers and that the population of minorities has increased. We also know that increasing problems related to unemployment, inadequate health insurance is a huge problem," Raghavan said. "Like global warming, this is not something we're going to be worrying about in fifty years. It's here. It's happening now and, if we neglect it, we will have a catastrophe in the future."

More information

There's more on cancer health-care disparities at the U.S. National Cancer Institute.



SOURCES: April 29, 2009, teleconference with Richard L. Schilsky, M.D., professor, medicine, University of Chicago, and president, American Society of Clinical Oncology; Derek Raghavan, M.D., Ph.D., director, Cleveland Clinic Taussig Cancer Institute, and co-chair, ASCO Health Disparities Advisory Group; Benjamin Smith, M.D., chief, radiation oncology, Wilford Hall Medical Center, Lackland Air Force Base, San Antonio


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