Improving Cancer Outcomes Among African Americans

June 12, 2024

Cancer screenings are important for everyone. They can catch cancer early, and in some cases, prevent it from developing altogether.

However, African Americans face more obstacles to cancer care and are less likely to be up-to-date on recommended screenings. Because of this, cancer is often diagnosed at a later stage in African Americans, leading to lower survival rates, says University Hospitals internal medicine physician Gregory Hall, MD.

Receiving cancer screenings at the recommended times is the key to both helping prevent cancer and improving cancer outcomes in the African American community.

"The improvements in cancer screening have been miraculous,” says Dr. Hall. “As a Black community, we need to dispel the myths and get on board with finding cancer early rather than ‘hoping’ it never comes. Almost any type of cancer is easier to treat and cure when it is found earlier.”

Cancer Rates Among African Americans

African Americans have higher diagnosis rates for certain cancers and have the lowest survival rate among all racial groups for seven of the top eight cancer types. Data shows that:

African Americans under the age of 50 are two times more likely to be diagnosed with colon cancer than white people under 50.
Black women, though less likely to be diagnosed with breast cancer, are 40 percent more likely to die from the disease, and twice as likely to die if they are over 50.
Black men are 70 percent more likely to get diagnosed with prostate cancer and the risk of death is more than double that of every other racial and ethnic group.
Lung cancer is the leading cause of cancer deaths in African Americans; they are 15 percent less likely to be diagnosed early and 16 percent less likely to survive five years compared to white people.

Screenings Guidelines For Detecting Cancer Early

Screenings exist for all of the above cancer types. Getting screened on schedule is the best way to catch cancer early, or to find and remove pre-cancerous tissue before it turns into cancer. Expert recommend the following guidelines for cancer screenings:

Colon cancer screening: Colonoscopy screenings are recommended beginning at age 45. This screening looks for and removes suspicious polyps that are the precursors to cancer. Follow-up screenings will vary based on test results and are typically repeated within 10 years. If you have a personal or family history of colorectal cancer, colorectal polyps or inflammatory bowel disease, you may need to be tested earlier or more frequently.

Home stool screening tests like Cologuard® allow laboratory detection of colon cancer cells once collected and sent to a lab. These tests are done every three years if normal, and if abnormal, requires a follow-up colonoscopy.

Prostate cancer screening: For years, men avoided getting screened for prostate cancer for fear of a rectal exam. But now, only a blood test is needed. The American Cancer Society recommends a baseline prostate-specific antigen (PSA) test at age 45 for men who are at high risk of developing prostate cancer – which includes African American men. Some men at higher risk due to family or personal history may need to begin testing at age 40. Follow-up testing will depend on individual risk factors, but generally is yearly.

Breast cancer screening: Mammograms are recommended starting at age 40 for all women, followed by a mammogram annually. When breast cancer is caught in its earliest stages, it can dramatically increase the odds of successful treatment and survival. Breast cancer found early can be removed and managed with minimal disruption of your life.

Lung cancer screening: Lung cancer screenings can be conducted with a low-dose computed tomography (CT) scan. This screening should start at age 50 if you're a current smoker or quit smoking within the last 15 years and smoked a pack a day for 20 years or more. The low-dose CT scan can detect pre-cancerous lung nodules, which can then be monitored for signs of cancer.

Other recommended cancer screenings include:

Cervical cancer screenings: women should have a Pap test at least every three years, beginning at age 21, to screen for cervical cancer.

Skin cancer screenings: A skin check exam is recommended once a year to look for any abnormal moles or growths that could be signs of skin cancer.

Other Cancer Prevention Strategies

In addition to screenings, vaccines are available that can help prevent certain kinds of cancer. These include the hepatitis B vaccine, which can help prevent liver cancer. African Americans have the highest rates of liver cancer and the lowest rate of receiving the hepatitis B vaccination, says Dr. Hall. Another important vaccine prevents human papillomavirus, or HPV, which causes genital warts that can lead to cervical cancer and other cancers.

Certain lifestyle choices can also be helpful for overall health and helping to prevent cancer. These include:

Don't use tobacco. Smoking has been linked to many types of cancer, including cancer of the lung, mouth, throat, voice box, pancreas, bladder, cervix and kidney. Even being around secondhand smoke might increase the risk of lung cancer. Some experts believe that smoking menthol cigarettes, which the majority of Black smokers use, makes it harder to quit. If you want to prevent cancer, stopping tobacco is the first step.
Eat a healthy diet. Base your diet on fruits, vegetables and other foods from plant sources — such as whole grains and beans. Limit refined sugars and fat from animal sources, as well as processed meats. Eating processed meat often can slightly increase the risk of certain types of cancer. Processed meats include hotdogs, deli meat, corned beef, and pepperoni.
Maintain a healthy weight. Being at a healthy weight might lower the risk of some types of cancer, such as breast, prostate, lung, colon and kidney cancers.
Stay physically active. Besides helping to control weight, physical activity on its own might lower the risk of breast cancer and colon cancer. Strive for at least 150 minutes a week of moderate aerobic activity or 75 minutes a week of hard aerobic activity. Aerobic activity occurs when your heart beats harder than normal. As a general goal, include at least 30 minutes of physical activity in your daily routine.
Drink alcohol only in moderation, if at all. Alcohol increases the risk of various types of cancer, including cancer of the breast, colon, lung, kidney, and liver. Drinking more increases the risk.

Dr. Hall says that this list may seem overwhelming at first, but small incremental changes in lifestyle are achievable and can be very effective.

“Knowledge is power, and small decisions can make a big difference down the road,” he says.

Dr. Hall says that while we can’t change our past behavior we can start making changes going forward, including making sure to get screened so that cancer – if it develops – can be found and treated early. Your primary care provider can assist you with learning what screenings you should have and getting them scheduled.