The disproportionate burden of cancer on African-Americans and the poor took center stage in the American Cancer Society's annual cancer report, a first in its 52 years of publication.
While higher incidence and death rates of cancer suffered by blacks have been emphasized in past reports, the subject has never before been given its own 15-page special section. It was released Wednesday, the day after the federal government was accused of softening its own report on health inequities.
Overall, black men have a 40 percent higher death rate from all cancers compared with white men, and they are twice as likely to die of prostate cancer as white men, the report states. Nationally, black women die at a 20 percent higher rate than white women.
"Cancer Facts & Figures: 2004" is a summary of current scientific data. It is widely distributed and considered one of the most referenced cancer documents in the nation. Tobacco use and obesity have been subjects of past special sections.
About 1.4 million Americans will be diagnosed with cancer in 2004, and 563,700 will die of the disease, the report estimates. Georgia is predicted to have 35,430 new cancer cases and 14,600 cancer deaths this year.
While death rates for American men, overall, have been steadily declining about 1.5 percent annually the past decade, women's rates have remained the same and the gap between the death rates of blacks and whites is larger than it was 30 years ago.
Tuesday, the Department of Health and Human Services and Bush administration were accused by eight congressional Democrats of watering down health inequalities while revising a report.
The American Cancer Society, meanwhile, took a different tack. Eliminating cancer disparities by 2015 is one of the organization's most important goals, said CEO John Seffrin.
The poor and medically underserved continue to be left out of the scientific and societal strides made in prevention, early detection, and treatment of cancer, Seffrin said.
"While it is true more Americans were saved from cancer last year, it is also true that Americans suffered and died needlessly last year and it doesn't have to be that way," he said.
Poverty, lack of health insurance, lack of access to transportation and to health care, and distrust of doctors are among reasons cited in many health disparities, including HIV/AIDS, heart disease and diabetes.
In addition, many studies show that African-Americans are more likely to be diagnosed with late-stage cancer, which is more difficult to treat and stop from spreading. In addition, many may not follow through with lifesaving radiation and chemotherapy regimens.
In Georgia, the black-white gap is even larger, state statistics show.
Black men die from prostate cancer at a rate 2 1/2 times greater than white men in Georgia, and breast cancer kills black women at a rate one-third greater than white women.
No one is more aware of these two worlds of cancer than Dr. Otis Brawley, director of the Grady Center of Excellence, a new program aimed at reducing cancer deaths among minorities and the poor.
"It's a question of the 'haves' and 'have-nots,' not a question of black and white," asserts Brawley, who is also affiliated with Emory's Winship Cancer Institute.
"Race matters, certainly, because there's a higher proportion of African-Americans who are low-income."
The recognition of the extent of the racial cancer gap by one of the world's largest cancer organizations is significant, said Brawley, who is African-American and has spent decades documenting cancer differences.
"It's gratifying because, let's face it, the American Cancer Society is largely an upper-class white organization. I never thought I would be in such agreement with them."
Copyright 2004 The Atlanta Journal-Constitution