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1、Cancer Facts&Figuresfor African American/Black People 2022-2024ContentsBasic Cancer Facts 1Introduction 1What Is Cancer?2Can Cancer Be Prevented?2Factors That Influence Cancer Disparities 3Structural Racism 3Socioeconomic Status 4Access to Care 4Comorbidities(Other Health Conditions)8Medical Mistrus
2、t and Health System Implications 9Cancer Occurrence in Black People 11How Many Black Americans Alive Today Have Ever Had Cancer?11What Is the Risk of Developing or Dying of Cancer?11How Many New Cancer Cases and Deaths Are Expected in 2022?12Does Cancer Occurrence Vary by State?12How Has Cancer Occu
3、rrence Changed over Time?12Major Differences in the Cancer Burden between Black and White People 12Selected Cancers 14Female Breast 14Colon and Rectum 16Lung and Bronchus 17Myeloma 18Prostate 19Stomach 20Uterine Cervix 21Uterine Corpus(Endometrial)21Risk Factors for Cancer 22Tobacco 22Excess Body We
4、ight,Alcohol,Diet,and Physical Activity 24Infectious Agents 29Cancer Screening 32Breast Cancer Screening 32Cervical Cancer Screening 32Colorectal Cancer Screening 32Lung Cancer Screening 33Prostate Cancer Screening 33How the American Cancer Society Helps Reduce Cancer Disparities 33Cancer Prevention
5、 and Early Detection 34Support for Quitting Tobacco 34Patient and Caregiver Services 35Research 36Advocacy 36Additional Resources 38Sources of Statistics 39References 40American Cancer Society Recommendations for the Early Detection of Cancer in Average-risk Asymptomatic People 492022,American Cance
6、r Society,Inc.All rights reserved,including the right to reproduce this publication or portions thereof in any form.For permission,email the American Cancer Society Legal department at permissionrequestcancer.org.This publication attempts to summarize current scientific information about cancer.Exce
7、pt when specified,it does not represent the official policy of the American Cancer Society.Suggested citation:American Cancer Society.Cancer Facts&Figures for African American/Black People 2022-2024.Atlanta:American Cancer Society,2022.Cancer Facts&Figures for African American/Black People 2022-2024
8、 1Basic Cancer Facts Introduction In 2020,there were 46.9 million Americans who identified as Black or African American,accounting for 14.2%of the total US population.1,2 The Black population is the third-largest racial/ethnic group following White and Hispanic people and primarily resides in the So
9、uth (Figure 1).The population includes ancestors of individuals brought to the US as slaves who largely identify as African American,as well as nearly 10%who are recent immigrants,mostly of African or Caribbean descent.The Black immigrant population has increased 5-fold over the past four decades,fr
10、om 816,000 in 1980 to more than 4.3 million in 2019.3 Although racial classification is a social construct based on appearance,it remains useful for describing health patterns in the US because long-standing structural racism has contributed to inequalities in the social determinants of health.Altho
11、ugh some cancer-associated genetic mutations are inherited,most health differences between population groups do not stem from biology,but from variations in socioeconomic status and access to medical care.Collectively,Black people have the highest death rates and shortest survival rates of any racia
12、l/ethnic group in the US for most cancers,largely driven by social mechanisms that are further explained on page 3.Notably,Black immigrants have lower cancer mortality than US-born Black people,highlighting the importance of where a person lives over race or biology.4 Figure 1.Non-Hispanic Black Pop
13、ulation as a Percentage of Total County Population,2020Source:US Census Bureau,2020 Decennial Census Redistricting Data.Released September 2021.2022,American Cancer Society,Inc.,Surveillance and Health Equity Science51.2 or more32.7 to 51.117.7 to 32.66.4 to 17.6Less than 6.4Percent 2 Cancer Facts&F
14、igures for African American/Black People 2022-2024This report presents statistics on cancer incidence,mortality,survival,and risk factors for Black people in the US.Additional information is given for selected cancer sites,chosen due to their large disparity and impact on the Black population.When p
15、ossible,data are confined to non-Hispanic Black people,who account for approximately 94%of the total Black population,to limit racial misclassification.It is intended to provide information to cancer control advocates,community leaders,public health and health care workers,and others interested in c
16、ancer prevention,early detection,and treatment in the Black community.What Is Cancer?Cancer is a group of diseases characterized by uncontrolled growth and spread of abnormal cells.If the spread is not controlled,it can result in death.Although the causes of cancer are not completely understood,nume
17、rous factors are known to increase risk,including many that are modifiable(e.g.,tobacco use and excess body weight)and some that are not(e.g.,inherited genetic mutations and immune conditions).These risk factors may act simultaneously or in sequence to initiate and/or promote cancer growth.Can Cance
18、r Be Prevented?A substantial proportion of cancer is preventable,including all cancers caused by tobacco use.Overall,at least 42%of newly diagnosed cancers are potentially avoidable,including the 19%caused by smoking and the 18%caused by a combination of excess body weight,physical inactivity,excess
19、 alcohol consumption,and poor nutrition.5 Many of the cancers caused by infectious organisms can also be prevented through behavioral changes,vaccination,or treatment of the infection.For more information on cancer risk factors,see page 22.Screening can prevent colorectal and cervical cancers throug
20、h the detection and removal of precancerous growths,as well as reduce mortality from cancers of the breast,colon,rectum,cervix,prostate,and lung and bronchus(among current or former heavy smokers)through early detection.A heightened awareness of changes in certain areas of the body,such as breast,sk
21、in,mouth,eyes,or genitalia,may also result in the early detection of cancer.For more information on cancer screening,see page 32.Table 1.Leading Causes of Death among Black and White People,US,2019MalesBlackWhiteCause of DeathRankNumber%Death Rate*RankNumber%Death Rate*143,63324%264.91277,82825%209.
22、9235,56720%210.42245,90422%178.2315,3378%77.2378,9757%73.748,9865%57.6546,5896%35.7Heart diseasesCancerAccidents(unintentional injuries)Cerebrovascular diseaseAssaults(homicides)&legal interventions58,8545%40.6183,8231%4.0All causes182,3411,079.61,118,660865.5FemalesBlackWhiteCause of DeathRankNumbe
23、r%Death Rate*RankNumber%Death Rate*137,95023%163.21235,84522%128.9235,27721%146.92216,16020%130.1311,0897%48.4564,4716%35.047,5675%32.2723,8332%14.2Heart diseasesCancerCerebrovascular disease DiabetesAccidents(unintentional injuries)56,6174%29.0646,7804%36.2All causes166,420716.21,070,907623.5Race i
24、s exclusive of Hispanic ethnicity.*Rates are per 100,000 and age adjusted to the 2000 US standard population.Source:National Center for Health Statistics,Centers for Disease Control and Prevention,2021.2022,American Cancer Society,Inc.,Surveillance and Health Equity ScienceCancer Facts&Figures for A
25、frican American/Black People 2022-2024 3Factors That Influence Cancer Disparities Structural Racism As noted earlier,the underlying source of health disparities among people of color is structural racism,which is discrimination perpetuated through interconnected institutions and reinforced through c
26、ulture,history,ideology,and sanctioned practices.Structural racism impacts all facets of life to limit the accumulation of wealth and overall standard of living through unequal access to work,education,housing,healthy food,and quality health care.6,7 One example of structural racism is redlining,a h
27、istorically legal form of lending discrimination in which creditworthy applicants who lived in poor neighborhoods,usually with a large Black population,were refused loans for housing improvement and purchase.This practice facilitated segregation by preventing Black people from gaining home equity an
28、d entering middle or upper class neighborhoods,and continues to influence health today.8 Areas with historical redlining and/or current lending bias are associated with increased risk of late-stage cancer diagnosis9 and have 2 times higher breast cancer mortality rates than other areas.10 Other exam
29、ples of Table 2.Lifetime Probability of Developing or Dying from Invasive Cancer by Race and Sex,US,2016-2018*DevelopingDyingBlack(%)NH White(%)Black(%)NH White(%)All sitesMale37.8(1 in 3)41.0(1 in 2)20.2(1 in 5)20.8(1 in 5)Female34.3(1 in 3)39.9(1 in 3)17.9(1 in 6)18.2(1 in 5)BreastFemale11.6(1 in
30、9)13.6(1 in 7)3.0(1 in 33)2.5(1 in 39)Colon&rectumMale4.2(1 in 24)4.2(1 in 24)2.0(1 in 49)1.7(1 in 58)Female4.0(1 in 25)3.9(1 in 25)1.8(1 in 55)1.6(1 in 63)Kidney&renal pelvisMale1.9(1 in 52)2.3(1 in 44)0.5(1 in 215)0.6(1 in 172)Female1.3(1 in 80)1.3(1 in 79)0.3(1 in 367)0.3(1 in 306)LeukemiaMale1.2
31、(1 in 82)2.0(1 in 50)0.6(1 in 161)1.0(1 in 101)Female1.0(1 in 104)1.4(1 in 72)0.5(1 in 185)0.7(1 in 144)Liver&intrahepatic bile ductMale1.6(1 in 63)1.2(1 in 85)1.2(1 in 85)0.9(1 in 111)Female0.6(1 in 164)0.5(1 in 200)0.6(1 in 171)0.5(1 in 209)Lung&bronchusMale6.1(1 in 16)6.7(1 in 15)4.8(1 in 21)5.2(
32、1 in 19)Female4.9(1 in 21)6.7(1 in 15)3.5(1 in 29)4.6(1 in 22)MyelomaMale1.5(1 in 66)0.9(1 in 113)0.7(1 in 147)0.4(1 in 231)Female1.4(1 in 70)0.6(1 in 162)0.6(1 in 156)0.3(1 in 301)OvaryFemale0.9(1 in 108)1.2(1 in 83)0.7(1 in 151)0.9(1 in 113)ProstateMale16.7(1 in 6)12.0(1 in 8)3.8(1 in 26)2.3(1 in
33、44)StomachMale1.2(1 in 81)0.8(1 in 122)0.7(1 in 149)0.3(1 in 311)Female0.9(1 in 113)0.5(1 in 210)0.4(1 in 225)0.2(1 in 487)ThyroidMale0.3(1 in 336)0.8(1 in 132)0.1(1 in 2,802)0.1(1 in 1,718)Female1.1(1 in 90)1.9(1 in 52)0.1(1 in 1,553)0.1(1 in 1,562)Urinary bladderMale1.8(1 in 55)4.3(1 in 23)0.5(1 i
34、n 187)1.0(1 in 101)Female0.8(1 in 121)1.3(1 in 76)0.3(1 in 296)0.4(1 in 284)Uterine cevixFemale0.8(1 in 131)0.6(1 in 180)0.3(1 in 315)0.2(1 in 516)Uterine corpusFemale3.1(1 in 32)3.2(1 in 31)1.0(1 in 97)0.6(1 in 167)NH:non-Hispanic.Estimates are unavailable for NH Black.*For those who have not been
35、previously diagnosed with cancer.All sites excludes basal and squamous cell skin cancers and in situ cancers except urinary bladder.Includes in situ cancers.Note:Percentages and“1 in”numbers may not be equivalent due to rounding.Source:DevCan:Probability of Developing or Dying of Cancer Software,Ver
36、sion 6.7.92022,American Cancer Society,Inc.,Surveillance and Health Equity Science4 Cancer Facts&Figures for African American/Black People 2022-2024discriminatory practices include the diversion from historically Black neighborhoods of public transportation,grocery stores,and public green spaces,all
37、 of which limits the availability of affordable healthy food and opportunities for physical activity.7,11,12 Additionally,this environment increases the prevalence of chronic stress,infectious disease,and other exposures that contribute to poorer health.6,7,11-14 Socioeconomic Status As a result of
38、this historical context and social structure,race is strongly correlated with socioeconomic status(SES)in the United States.During 2019-2020,19%of Black people were living below the federal poverty level compared to 7%of White people,and only 28%had completed four years of college compared to 41%of
39、Whites.15,16 Cancer risk and mortality increase with decreasing SES,regardless of race/ethnicity.This is largely because of higher prevalence of cancer risk factors due to marketing strategies that target low-income populations;environmental and community factors mentioned in the previous section;an
40、d unequal access to high-quality care.However,Black people have higher death rates than White people at every level of SES.17,18 Although racial disparities in cancer mortality have begun to narrow,socioeconomic disparities have widened over the past several decades.18 Access to Care Access to healt
41、h care influences the use of prevention and early detection services(e.g.,tobacco cessation counseling and cancer screening),as well as receipt of cancer treatment and survivorship care.One of the largest obstacles to high-quality care is cost,which is exacerbated for Black people by disproportionat
42、ely low insurance coverage.In the US,insurance coverage is closely tied to employment.However,Black people are further disadvantaged by having a higher likelihood of inadequate health insurance even with employment.7 Compared to their uninsured counterparts,people with health insurance are more like
43、ly to have a usual source of Figure 2.Leading Sites of New Cancer Cases and Deaths among Black People in US 2022 Estimates*Estimated New CasesMaleFemaleMaleFemaleEstimated Deaths*Estimates are rounded to the nearest 10,and exclude basal and squamous cell skin cancers and in situ cancers with the exc
44、eption of urinary bladder.Ranking is based on modeled projections and may differ from the most recent observed data.Source:Estimated new cases are based on 2004-2018 incidence data reported by the North American Association of Central Cancer Registries.Estimated deaths are based on 2005-2019 US mort
45、ality data from the National Center for Health Statistics,Centers for Disease Control and Prevention.See Sources of Statistics on page 39 for more information.2022,American Cancer Society,Inc.,Surveillance and Health Equity ScienceLung&bronchus 7,890 22%Prostate 6,040 17%Colon&rectum 3,890 11%Pancre
46、as 3,040 8%Liver&intrahepatic bile duct 2,720 7%Myeloma 1,260 3%Leukemia 1,130 3%Stomach 1,060 3%Non-Hodgkin lymphoma 890 2%Urinary bladder 870 2%All sites 36,430 Breast 6,800 18%Lung&bronchus 6,270 17%Colon&rectum 3,310 9%Pancreas 3,300 9%Uterine corpus 2,680 7%Ovary 1,480 4%Myeloma 1,270 3%Liver&i
47、ntrahepatic bile duct 1,150 3%Leukemia 1,040 3%Uterine cervix 780 2%All sites 37,250 Prostate 41,600 37%Lung&bronchus 13,200 12%Colon&rectum 10,590 9%Kidney&renal pelvis 6,340 6%Liver&intrahepatic bile duct 4,140 4%Pancreas 4,010 4%Myeloma 3,840 3%Non-Hodgkin lymphoma 3,630 3%Urinary bladder 3,420 3
48、%Leukemia 3,090 3%All sites 111,990 Breast 36,260 32%Lung&bronchus 12,490 11%Colon&rectum 10,110 9%Uterine corpus 9,030 8%Pancreas 4,410 4%Kidney&renal pelvis 4,010 4%Myeloma 3,970 4%Non-Hodgkin lymphoma 3,240 3%Thyroid 2,890 3%Leukemia 2,650 2%All sites 112,090 Cancer Facts&Figures for African Amer
49、ican/Black People 2022-2024 5Table 3.Incidence Rates*for Selected Cancers in Black People by Sex and State,2014-2018StateAll CancersLung&BronchusColon&RectumProstateBreastMaleFemaleMaleFemaleMaleFemaleMaleFemaleAlabama537.4385.982.537.454.641.5186.6126.7Alaska389.2344.8138.1108.2Arizona407.2331.259.
50、641.233.029.9121.5105.3Arkansas601.8413.5108.651.860.346.5195.9121.6California467.3390.361.745.843.634.9141.4126.1Colorado441.7339.651.234.439.134.9142.6113.7Connecticut516.6396.370.145.243.631.4175.8128.7Delaware534.5418.272.753.450.134.3196.0138.7District of Columbia518.5431.069.752.053.337.4149.0
51、140.4Florida465.6381.458.332.845.133.7147.9111.1Georgia557.3400.978.740.052.638.6196.6131.2Hawaii468.8348.348.0179.7116.8Idaho496.9331.7154.5Illinois561.1444.989.662.659.943.4175.2137.0Indiana529.8406.982.357.950.937.3165.3125.8Iowa597.0473.596.468.457.240.2178.9127.3Kansas515.6419.678.952.644.237.5
52、162.0132.0Kentucky551.4451.6101.970.655.641.5160.6128.8Louisiana593.8424.596.445.761.044.9184.8136.1Maine382.0305.5135.382.6Maryland521.5406.463.847.746.734.2190.7133.0Massachusetts475.6384.754.438.744.330.3177.4119.6Michigan529.9408.883.257.551.938.5159.3121.2Minnesota547.8403.476.652.444.931.0169.
53、0108.5Mississippi596.0408.0105.946.068.246.3192.2125.0Missouri537.6431.796.065.251.239.4146.2133.9Montana514.2Nebraska599.3435.473.367.456.039.0206.0112.0Nevada384.9345.048.646.043.432.9110.1108.8New Hampshire376.0278.4158.3New Jersey560.1430.566.446.651.838.4207.0134.5New Mexico393.6331.961.647.230
54、.8128.4103.9New York545.9404.561.640.447.834.1203.0124.1North Carolina553.9407.988.446.147.634.2182.3137.2North Dakota251.4222.394.9Ohio519.5412.587.660.645.034.8161.0127.3Oklahoma514.7394.084.348.947.537.5166.6126.1Oregon538.9385.075.653.434.329.8173.3115.8Pennsylvania553.0448.885.066.846.636.4160.
55、7127.9Rhode Island415.6368.172.551.630.723.1128.3114.3South Carolina528.7386.283.939.152.734.8167.8128.8South Dakota390.6238.6120.2Tennessee559.3403.593.350.654.839.0182.8123.9Texas524.6395.080.045.355.338.6161.1120.6Utah444.9343.9159.8107.1Vermont418.5312.1Virginia498.0392.374.746.346.533.5162.7134
56、.8Washington471.9389.463.247.740.034.2140.0110.6West Virginia533.8374.591.951.248.735.1174.4119.9Wisconsin670.5492.8118.972.959.243.0196.6141.5Wyoming305.2204.3US529.2405.377.447.250.437.1172.6127.1Race is exclusive of Hispanic ethnicity.*Rates are per 100,000 and age adjusted to the 2000 US standar
57、d population.Rates are suppressed when there are fewer than 25 cases.Data from this registry is not included in US combined rates because they did not consent or because they did not meet NAACCR high-quality standards for all years during 2014-2018.Colon&rectum incidence for this state includes appe
58、ndix cancer.Source:North American Association of Central Cancer Registries,2021.2022,American Cancer Society,Inc.,Surveillance and Health Equity Science6 Cancer Facts&Figures for African American/Black People 2022-2024Table 4.Death Rates*for Selected Cancers in Black People by Sex and State,2015-201
59、9StateAll CancersLung&BronchusColon&RectumProstateBreastMaleFemaleMaleFemaleMaleFemaleMaleFemaleAlabama241.0150.265.325.125.316.240.727.6Alaska188.9106.5Arizona184.7134.742.824.718.513.432.527.6Arkansas251.0166.074.934.525.619.740.228.2California215.2157.146.129.520.914.942.630.4Colorado195.0128.840
60、.422.520.211.943.926.2Connecticut188.8133.441.624.514.510.233.222.6Delaware200.5157.347.435.517.912.932.627.8District of Columbia239.9176.650.728.924.717.039.633.6Florida190.5137.040.620.620.413.734.825.4Georgia218.4142.052.524.223.414.441.527.4Hawaii139.7119.0IdahoIllinois248.4175.162.538.428.318.0
61、43.631.9Indiana233.1158.759.436.923.915.238.527.4Iowa232.8164.455.246.221.816.435.820.9Kansas219.7167.651.738.617.314.035.027.3Kentucky232.2157.664.641.423.915.335.125.7Louisiana255.2162.572.031.826.816.934.529.8Maine144.0149.4Maryland211.6148.345.829.321.113.937.027.4Massachusetts171.4118.531.719.8
62、16.29.134.819.6Michigan224.2163.758.136.523.315.433.528.8Minnesota205.5146.650.727.515.211.828.223.4Mississippi268.1161.579.230.628.017.046.829.5Missouri247.8166.466.940.623.114.737.828.9MontanaNebraska239.6166.249.637.424.715.649.031.4Nevada202.8150.243.030.127.116.637.132.8New Hampshire151.3New Je
63、rsey210.2155.045.227.422.715.039.729.1New Mexico186.4114.839.034.927.0New York181.8136.338.022.117.813.032.925.4North Carolina234.6148.760.528.221.613.940.127.1North Dakota219.7Ohio232.3162.163.437.522.614.934.928.2Oklahoma239.7168.663.134.026.918.242.830.7Oregon223.0132.844.829.717.539.125.2Pennsyl
64、vania237.0172.957.639.021.015.539.029.4Rhode Island153.8112.138.323.121.4South Carolina236.9148.158.225.024.814.341.027.7South Dakota162.0Tennessee251.1162.368.133.727.416.442.429.3Texas225.5152.756.828.725.715.934.529.3Utah170.8135.6VermontVirginia221.9147.653.428.723.714.437.428.2Washington190.313
65、3.839.226.514.913.231.021.5West Virginia246.7167.163.337.525.516.236.632.9Wisconsin270.7179.975.242.722.614.938.627.8WyomingUS221.4152.154.029.222.714.837.928.0Race is exclusive of Hispanic ethnicity.*Rates are per 100,000 and age adjusted to the 2000 US standard population.Rates are suppressed when
66、 there are fewer than 25 deaths.Source:National Center for Health Statistics,Centers for Disease Control and Prevention,2021.2022,American Cancer Society,Inc.,Surveillance and Health Equity ScienceCancer Facts&Figures for African American/Black People 2022-2024 7Figure 3.Trends in Death Rates*for Se
67、lected Cancer Sites among Black and White People,US,1975-2019ProstateRate per 100,000Rate per 100,000Breast0204060801----050----811975-76Rate per 100,000Colon&rectumColon&rectumRa
68、te per 100,000Rate per 100,000010203040----0----811975-76All sitesAll sitesRate per 100,000Rate per 100,00005003003504---911985-8
69、-7605003003504----811975-76Lung&bronchusRate per 100,000Lung&bronchus02550751001251----001251----811975-
70、76Race includes Hispanic ethnicity.*Rates are age adjusted to the US standard population and are 2-year moving averages.Source:National Center for Health Statistics,Centers for Disease Control and Prevention,2021.2022,American Cancer Society,Inc.,Surveillance and Health Equity ScienceBlackWhiteMaleF
71、emale 8 Cancer Facts&Figures for African American/Black People 2022-2024care,utilize preventive services,and seek care when it is needed.19 Conversely,individuals without health insurance are more likely to be diagnosed with advanced cancer and have a higher risk of cancer death compared to people w
72、ho are privately insured.20-22 For example,colorectal cancer patients with stage II disease who have health insurance are more likely to survive 5 years than uninsured people with stage I disease.23 Studies show that equal treatment reduces racial disparities.24-26 The 2010 passage of the Affordable
73、 Care Act(ACA)and subsequent expansion of Medicaid by many states has helped to mitigate the financial burden of health care and reduce the number of people who are uninsured,particularly among those with lower SES.People of color have had the largest gains,27 with the uninsured rate declining from
74、20%in 2010 to 12%in 2019 in Black people and from 14%to 9%in White people.28,29 However,people of color are still more likely to be uninsured and are disproportionately represented in states that did not expand Medicaid.27(For more information about how the ACA influences people diagnosed with cance
75、r,see the Advocacy section on page 36.)Even when Black people do have access to care it is more often of lower quality compared to White people.7 Comorbidities (Other Health Conditions)Discriminatory practices and disproportionate poverty also contribute to a higher prevalence of other chronic disea
76、ses,which may increase cancer risk independently and/or through shared risk factors,as well as reduce the likelihood of cancer survival.30 For instance,diabetes increases risk of cancer incidence and mortality,and is more common among Black people than any other racial/ethnic group.31,32(For more in
77、formation about diabetes,see page 29.)The death rate for diabetes is about two times higher in Black people than in White people among both men and women(Table 1).Black people also have higher Table 5.Comparison of Cancer Incidence Rates between Black and White People,US,2014-2018MaleFemaleCancerBla
78、ck Rate*White Rate*Absolute DifferenceRate RatioCancerBlack Rate*White Rate*Absolute DifferenceRate RatioKaposi sarcoma1.60.41.24.32Kaposi sarcoma0.199 9999 9930 309698ProstateFemale breast9699203082928778Stomach020406080100All StagesDistantRegionalLocalized8892505912185667Uterine cervixUterine corp
79、us8796527219116384Race is exclusive of Hispanic ethnicity.*Survival rates are based on patients diagnosed between 2011 and 2017 and followed through 2018.Note:Myeloma does not have regional staging per staging system.Source:Surveillance,Epidemiology,and End Results(SEER)Program,18 Registries,Nationa
80、l Cancer Institute,2021.2022,American Cancer Society,Inc.,Surveillance and Health Equity Science BlackWhite666935316632 32 12 Cancer Facts&Figures for African American/Black People 2022-2024How Many New Cancer Cases and Deaths Are Expected in 2022?New cases:About 111,990 cancer cases in Black men an
81、d 112,090 in Black women are expected to be newly diagnosed in 2022(Figure 2).The most commonly diagnosed cancers are prostate,lung and bronchus(hereafter lung),and colon and rectum(hereafter colorectal)in Black men and breast,lung,and colorectal in Black women.These four cancers account for more th
82、an half of all new cases among Black people.Deaths:About 36,430 Black men and 37,250 Black women are expected to die of cancer in 2022(Figure 2).Lung cancer is the most common cause of cancer death among Black men(22%),followed by prostate cancer(17%),whereas breast cancer is the leading cause of ca
83、ncer death in Black women(18%),followed by lung cancer(17%).This is in contrast to the overall female population,among whom lung cancer is the leading cause of cancer death.Colorectal cancer is the third-leading cause of cancer death in Black men and women,similar to the general population.Does Canc
84、er Occurrence Vary by State?There is wide variation in cancer occurrence by state,particularly for cancers closely tied to behavioral factors like smoking(Table 3 and Table 4).For example,lung cancer incidence rates for Black men residing in the Southern states of Arkansas,Mississippi,and Kentucky a
85、re nearly twice those in Colorado and Nevada due to historically higher smoking prevalence that continues today.How Has Cancer Occurrence Changed over Time?Trends in Cancer Incidence Since the early 1990s,incidence rates for all cancers combined have generally declined in Black men and remained stab
86、le in Black women.Patterns among Black men largely reflect declines in cancers of the prostate,lung,and colorectum.Whereas,among women,declines in lung and colorectal cancer are offset by increasing incidence of uterine corpus and breast cancer,though the trend for breast cancer has recently slowed
87、and is approaching stabilization.Trends in Cancer Mortality Overall cancer death rates increased from the mid-1970s until 1991 at a much steeper pace in Black people than in White people,especially among men(Figure 3),largely driven by the tobacco epidemic.From 2010 to 2019,the death rate declined f
88、aster in Black men than in White men(3%versus 2%per year)but the pace was similar among women(2%per year).The overall higher cancer death rates in Black people are largely due to cancers of the breast and colorectum in women and cancers of the prostate,lung,and colorectum in men.The more rapid progr
89、ess in recent years,especially among Black men,largely reflects steep declines for lung and other smoking-related cancers because of rapid reductions in smoking prevalence over the past 40 years.(For more information on smoking,see page 22.)As a result,the Black-White disparity narrowed among men(Fi
90、gure 3).Major Differences in the Cancer Burden between Black and White People Incidence and Death Rates The risk of developing cancer is higher in Black than in White people for many cancers,especially those associated with infectious agents,such as stomach,liver,and cervical cancers.Table 5 and Tab
91、le 6 show cancer incidence,mortality rates,and rate ratios in Black versus White people.Rate ratios greater than 1 indicate a higher rate in Black people and rate ratios less than 1 indicate a higher rate in White people.Overall,Black men have 6%higher cancer incidence but 19%higher cancer mortality
92、 than White men,reflecting lower survival rates.Even more striking,Black women have 8%lower cancer incidence than White women,but 12%higher cancer mortality.This is partly driven by breast and uterine corpus cancers,for which Black women have slightly lower or similar incidence but 41%and 97%higher
93、mortality,respectively.Uterine corpus cancer incidence rates that are calculated using hysterectomy-adjusted population denominators(i.e.,only including women with an intact uterus who are at risk for this disease)are higher in Black than White Cancer Facts&Figures for African American/Black People
94、2022-2024 13Figure 6a.Trends in Incidence Rates*among Black People for Selected Cancers by Sex,1975-2018Year of diagnosisYear of diagnosisYear of deathLung&bronchusLung&bronchusBreastBreastColon&rectumColon&rectumUterine cervixUterine corpusMyelomaFemaleRate per 100,000Lung&bronchusProstateColon&rec
95、tumMyelomaStomachUterine corpusMyelomaMaleFemaleMale05003003----01001201----811975-76Race includes Hispanic ethnicity.*Rates are delay adjusted and age adjusted to 2000
96、 US standard population and 2-year moving averages.Source:SEER Program,9 SEER Registries,National Cancer Institute,2021.Figure 6b.Trends in Death Rates*among Black People for Selected Cancers by Sex,US,1975-2019Year of deathRate per 100,0000204060801001201---91
97、-25303540----811975-76Race includes Hispanic ethnicity.Rates are age adjusted to 2000 US standard population and 2-year moving averages.Source:National Center for Health Statistics,Centers for Disease Control and Prevent
98、ion,2021.2022,American Cancer Society,Inc.,Surveillance and Health Equity ScienceUterine cervixStomachLung&bronchusProstateColon&rectumStomachStomachMyeloma 14 Cancer Facts&Figures for African American/Black People 2022-2024women because Black women are more likely to have had a hysterectomy.Thus,th
99、e uterine cancer mortality disparity would be even higher if corrected for hysterectomy prevalence.The largest racial disparities in incidence and mortality are for stomach and prostate cancers and myeloma,with death rates more than 2-fold higher in Black people than in White people.In addition,inci
100、dence rates for Kaposi sarcoma(KS)are almost 4 times higher in Black people(Table 5).In the US,KS is a relatively rare cancer that primarily occurs among people infected with the human immunodeficiency virus(HIV),which is more common among Black people.(For more information on HIV infection,see page
101、 31.)Stage at Diagnosis and Survival Stage of disease is the extent or spread of cancer at the time of diagnosis and has a large influence on cancer survival.In this report,stage is broadly classified as localized,regional,or distant,the definitions for which are provided in the footnotes of Figure
102、4.For most cancers,Black people are more likely than White people to be diagnosed with an advanced(regional or distant)stage,when treatment is usually more extensive and less successful(Figure 4).A common measure of cancer survival is relative survival,which is the percentage of people with cancer w
103、ho are alive at a specified time following diagnosis(typically 5 years),divided by the percentage expected to be alive in the absence of cancer based on normal life expectancy.Although 5-year relative survival rates for all cancers combined are useful in monitoring trends over time and comparing sur
104、vival differences between groups,they do not predict individual prognosis because they do not account for many important factors that influence survival,such as tumor characteristics and other patient illnesses.The overall 5-year relative survival rate among Black people has increased from approxima
105、tely 27%during 1960-1963 to 63%during 2011-2017.Still,Black people continue to have lower 5-year survival than White people(68%)overall and for each stage of diagnosis for most cancer sites(Figure 5).Some of the largest racial disparities in 5-year relative survival include cancers of the oral cavit
106、y and pharynx(Black:51%;White:69%)and urinary bladder(Black:65%;White:78%).Most of the differences in survival are due to socioeconomic barriers that limit access to timely,appropriate,and high-quality medical care as opposed to biological differences.18,60,61 For more information on how socioeconom
107、ic status and access to care contribute to racial disparities,see Factors That Influence Racial Health Disparities,page 3.Selected Cancers Female Breast Incidence Breast cancer is the most commonly diagnosed cancer among Black women,with an estimated 36,260 new cases expected to be diagnosed in 2022
108、.Similar to the pattern among White women,incidence rates among Black women increased rapidly during much of the 1980s(Figure 6a),largely due to increased detection of asymptomatic lesions through newly introduced mammography screening.Recently,increases have slowed and are approaching stabilization
109、 in Black women,in contrast to continued increases among White women.During 2014-2018,the overall breast cancer incidence rate was 127.1 cases per 100,000 in Black women compared to 132.5 in White women(Table 5),although rates are higher among Black women younger than 40 years of age.62 As a result,
110、and also because of shorter life expectancy,the median age of diagnosis is younger for Black women,60 years compared to 64 for White women.62,63 Cancer Facts&Figures for African American/Black People 2022-2024 15Black women are twice as likely as women of other racial and ethnic groups in the US to
111、be diagnosed with triple negative breast cancer(TNBC),64 so called because the tumor lacks estrogen receptors,progesterone receptors,and human epidermal growth factor receptor-2.Women with TNBC generally have poorer outcomes because of few effective treatments.Nevertheless,Black women are still abou
112、t 30%more likely to die from these tumors than White women,partly because of lesser rates of surgery and chemotherapy.65 Black breast cancer survivors also have a much higher likelihood of being diagnosed with new cancers because young-onset receptor negative tumors,such as TNBC,are associated with
113、a higher risk of subsequent malignancies than other breast cancer subtypes.66 Although breast cancer in men is rare,Black men have a higher incidence of all breast cancer subtypes than White men,including a two-fold higher risk of TNBC.67 Black women are also more likely to be diagnosed with inflamm
114、atory breast cancer,a rare but aggressive subtype.68 Reasons for the Black-White variation in subtype distribution remain unclear,but do not appear to be completely explained by the differences in the prevalence of inherited genetic mutations.69 For more information about breast cancer subtypes,see
115、Breast Cancer Facts&Figures at cancer.org/statistics.Mortality An estimated 6,800 deaths from breast cancer are expected to occur among Black women in 2022,making it the leading cause of cancer death in this population.Improvements in early detection and screening have led to a decrease in mortality
116、 for Black women since 1990.However,because the decline began later and was slower compared to White women,this progress led to a widening disparity that peaked in 2011-2012(Figure 3).From 2010 to 2019,mortality rates continued to decrease in Black and White women by a little over 1%per year;from 19
117、90,the breast cancer death rate dropped by 30%in Black women versus 41%in White women.Breast cancer death rates in the most recent time period(2015-2019)are 41%higher in Black women compared to White women(Table 6).The racial disparity is largely due to more advanced stage at diagnosis;higher preval
118、ence of obesity,other comorbidities,and unfavorable tumor characteristics(e.g.,TNBC);and less access to high-quality treatment,likely due to financial barriers.70-72 Lack of private insurance and unfavorable tumor characteristics explain one-third and one-fifth of the disparity,respectively among wo
119、men with early-stage disease younger than 65 years of age.73 Although there are some differences between Black and White women in the prevalence of genetic variations,they do not appear to explain the survival gap.74 Prevention and Early Detection Potentially modifiable factors that increase breast
120、cancer risk include weight gain after the age of 18 and/or being overweight or obese(for postmenopausal breast cancers),menopausal hormone therapy(combined estrogen and progestin),alcohol consumption,and physical inactivity.75 Studies increasingly suggest that high consumption of non-starchy vegetab
121、les is associated with lower risk for hormone receptor-negative breast cancers.75,76 If confirmed,this would be especially relevant for Black women,who have a higher proportion of hormone receptor-negative breast cancer.64 Screening mammography can detect breast cancer at an early stage,when treatme
122、nt is often less intensive and more successful.However,effectiveness is influenced by both the quality of screening and the timeliness of follow-up.Black women are less likely than White women to have their imaging performed at a facility with the most current technology,such as digital breast tomos
123、ynthesis,77 and also have a longer time between abnormal results and follow-up.78-80 Despite similar self-reported screening prevalence,only 57%of breast cancers in Black women are diagnosed at a local stage compared to 67%in White women(Figure 4).A recent study found that over half of this disparit
124、y is due to differences in insurance coverage.81 For more information on breast cancer screening,see page 32.Survival and Stage Distribution The overall 5-year relative survival rate for breast cancers diagnosed in 2011-2017 was 82%for Black women compared to 92%for White women(Figure 5),partly due
125、to more advanced stage at diagnosis,as mentioned earlier.16 Cancer Facts&Figures for African American/Black People 2022-2024However,Black women have lower survival at every stage of disease,largely because of less access to high-quality health care,including receipt of care at low-resourced and/or u
126、naccredited facilities.74,78,79,82 The greater burden of TNBC in Black women also contributes to disparate outcomes,83,84 although research suggests that Black women have lower survival than White women regardless of molecular subtype.64 Visit cancer.org/statistics for additional information about b
127、reast cancer in the latest edition of Breast Cancer Facts&Figures Colon and Rectum Incidence Colorectal cancer is the third most common cancer in Black men and women,with an estimated 20,700 cases expected to be diagnosed in 2022.Black people have the second-highest incidence of colorectal cancer in
128、 the US,following the Alaska Native/American Indian population.Incidence rates are about 20%higher in Black people than in White people among both men and women(Table 5).However,incidence was historically higher in White people85 and the crossover occurred in the early 1990s because of changing patt
129、erns in risk factors and slower dissemination of screening among Black people.86-90 From 2009 to 2018,incidence rates for colorectal cancer decreased by about 3%per year among Black people versus 2%per year among White people.Overall trends mask increasing incidence among people younger than 50 year
130、s of age,which is much steeper in White people(2%per year)than in Black people(0.5%per year).85 Mortality An estimated 7,200 deaths from colorectal cancer are expected to occur among Black people in 2022.Colorectal cancer is the third-leading cause of cancer death in both Black men and women.89 Simi
131、lar to incidence rates,colorectal cancer mortality rates were historically higher in White people than in Black people(Figure 3),but have reversed and are now 44%higher in Black men and 31%higher in Black women compared to Whites(Table 6).This gap is two times larger than the disparity for incidence
132、 but has begun to shrink in recent years because of steeper declines in death rates from 2010 to 2019 in Black people(about 3%per year)than in White people(about 2%per year).One study estimated that 19%of the racial disparity in mortality can be attributed to less screening and 36%to lower stage-spe
133、cific survival among Black people.89 Prevention and Early Detection Major modifiable factors that increase risk for colorectal cancer include excess body weight,type 2 diabetes,physical inactivity(colon only),long-term smoking,high consumption of red or processed meat,low calcium intake,moderate to
134、heavy alcohol consumption,and very low intake of fruits and vegetables and whole-grain fiber.91,92 Vitamin D deficiency,which is more common among Black than White people,93 has also been associated with increased risk and may contribute to racial differences in disease occurrence and outcomes.94,95
135、 Many of these risk factors are described in the section on Risk Factors for Cancer on page 22.For adults ages 45 and older who are at average risk for the disease,colorectal cancer risk is also reduced through the use of screening tests that can detect and remove precancerous polyps,as well as dete
136、cting cancer at an early stage before symptoms develop.88-90 However,recommended colorectal cancer screening use in 2018 remained lower in Black people(65%up-to-date)than White people(68%)(Table 8).For more information on colorectal cancer screening,see page 32.Survival and Stage Distribution The 5-
137、year relative survival rates for colorectal cancer improved from 45%in 1975-1977 to 59%in 2011-2017 among Black people versus 50%to 65%among White people.Some of the survival disparity is due to later-stage diagnosis among Black people,although this gap has narrowed:34%of colorectal cancers in Black
138、 people are diagnosed at a localized stage compared to 35%in White people(Figure 4).Five-year relative survival rates remain lower in Black than in White patients for each stage of diagnosis(Figure 5).Cancer Facts&Figures for African American/Black People 2022-2024 17Racial disparities in stage-spec
139、ific survival largely reflect differences in treatment,comorbidities,and tumor characteristics.22,96-99 Numerous studies have documented that Black people with colorectal cancer are less likely than White people to receive recommended surgical treatment,radiation,and chemotherapy.100-102 Additionall
140、y,Black people are more likely to have treatment delays,even within similar socioeconomic backgrounds,103 and are about 30%more likely than White people to be diagnosed with proximal(right-sided)tumors,which have less favorable outcomes.104 Visit cancer.org/statistics for more information on colorec
141、tal cancer in the latest edition of Colorectal Cancer Facts&Figures.Lung and Bronchus Incidence Lung cancer will be diagnosed in an estimated 25,690 Black people in 2022,and is the second most common cancer in both men and women.During 2014-2018,incidence rates were 12%higher in Black men than in Wh
142、ite men but 16%lower in Black women than in White women(Table 5).However,both Black men and women are more likely to be diagnosed with lung cancer at a younger age than Whites,with a median age at diagnosis of 67 versus 71,respectively.63 Lung cancer occurrence reflects historical differences in smo
143、king patterns,as over 80%of lung cancer cases overall are caused by smoking.5,105,106 Similar to White men,incidence rates in Black men increased rapidly until the mid-1980s because of widespread smoking uptake Figure 7.Trends in Incidence Rates*for Lung Cancer by Race,Sex,and Age,US,1997-2018Rate p
144、er 100,00020-49 years20-49 yearsRate per 100,000Year of diagnosisYear of diagnosis05000620032000020009200620032000199750+years50+years05003003504004502000920062003200050200250300350400450200092006200320001997Race
145、 is exclusive of Hispanic ethnicity.*Rates are age adjusted to the 2000 US standard population.Source:North American Association Central Cancer Registries,2021.2022,American Cancer Society,Inc.,Surveillance and Health Equity ScienceBlackWhiteMaleFemale 18 Cancer Facts&Figures for African American/Bl
146、ack People 2022-2024during the first half of the 20th century,but have since declined steadily due to reductions in smoking.In contrast,rates in Black women increased until the late 2000s before declining because of later and slower smoking uptake and cessation compared to men(Figure 6a).Steeper smo
147、king declines in Black people than in White people have resulted in a convergence in lung cancer incidence among young Black and White men and a crossover among women(Figure 7).106,107 From 2009 to 2018,the annual decline in incidence was about 3%in Black and White men,2%in Black women,and 1%in Whit
148、e women.Mortality Lung cancer is the leading cause of cancer death in Black men and the second-leading cause in Black women.An estimated 14,160 deaths from lung cancer are expected to occur among Black people in 2022.After increasing for decades,lung cancer death rates have declined since 1990 at a
149、generally faster pace in Black men than in White men,reducing the racial disparity from an excess of 40%in Black men in 1990-1992 to 15%in 2015-2019.In women,the downturn began about a decade later than that in men and is also steeper in Black than White women(Figure 3).Consequently,although Black a
150、nd White women had similar lung cancer mortality until the early 1990s,in 2015-2019 rates were 15%lower in Black women.The more favorable trends among Black people reflect the steep decline in smoking initiation unique to Black youth from at least the mid-1970s until the early 1990s.108,109 (For inf
151、ormation on smoking trends,see page 22.)During 2015-2019,the lung cancer death rate declined by about 6%per year in Black men,5%per year in White men,and 4%per year in Black and White women(Figure 6b).These accelerated trends reflect recent advances in lung cancer treatment,as well as reductions in
152、smoking.Prevention and Early Detection Combustible tobacco is the most important risk factor for lung cancer,accounting for about 80%of lung cancer deaths in the US among all races/ethnicities combined.5 Risk increases with both quantity and duration of tobacco use.For more information on tobacco us
153、e,see page 22.Screening with low-dose spiral computed tomography has been shown to reduce lung cancer mortality by 20%to 39%among current or former(quit within 15 years)heavy smokers.110,111 For more information on lung cancer screening,see page 33.Survival and Stage Distribution The 5-year relative
154、 survival rate for lung cancer is slightly lower in Black people than in White people overall,20%versus 22%,with the largest difference for localized-stage disease(55%versus 60%,Figure 5).Localized-stage lung cancer is only diagnosed in 21%of Black people and 25%of White people because symptoms gene
155、rally do not appear until the disease is advanced.Numerous studies have shown that even when lung cancer is diagnosed early,Black people are less likely than White people to receive surgery,which is the most effective treatment for survival.112-116 117 When treatment is equivalent,outcomes are simil
156、ar between Black and White individuals.118 Myeloma Incidence An estimated 7,810 new cases of multiple myeloma are expected to be diagnosed among Black people in 2022.Myeloma is a cancer of cells in the immune system called plasma cells.Incidence of myeloma is more than 2 times higher in Black people
157、 compared to White people(Table 5),and median age at diagnosis is younger(66 versus 70 years of age).63 Incidence continued to increase steadily in Black women by about 2%per year from 2009 through 2018,whereas rates in Black men may be stabilizing in recent years,resembling trends in White men.Mort
158、ality An estimated 2,530 myeloma deaths are expected to occur among Black men and women in 2022.Similar to incidence,mortality rates are about twice as high in Black people as in White people(Table 6).During 2015-2019,myeloma death rates declined by about 3%per year in Black women and 1%per year in
159、Black men and White men and women due to improved treatment.119,120 Cancer Facts&Figures for African American/Black People 2022-2024 19Prevention Excess body weight is the only known modifiable risk factor for myeloma;risk is about 20%higher in adults who are overweight or obese compared to people w
160、ho are normal weight.121 Higher rates of obesity among Black people(see Excess Body Weight on page 24)may contribute to the racial disparity for myeloma,122 especially among women.Myeloma is preceded by an asymptomatic premalignant condition known as monoclonal gammopathy of undetermined significanc
161、e(MGUS);individuals with MGUS have a risk of progression to myeloma of about 1%-2%per year.123 MGUS is also more prevalent and diagnosed at earlier ages in Black people than people of any other racial/ethnic group.124,125 A family history of blood cancers is also associated with increased risk that
162、is stronger among Black people than White people.126 Survival and Stage Distribution The 5-year relative survival rate has improved from 29%during 1975-1977 to 58%during 2011-2017 among Black people versus 24%to 55%among White people.The somewhat higher contemporary survival among Black people may r
163、eflect a lower prevalence of aggressive disease.127,128 Indeed,Black people have benefited less from recent improvements in treatment because of less access to care,lower utilization of new treatment,and more delays in treatment.127-130 Prostate Incidence An estimated 41,600 cases of prostate cancer
164、 are expected to be diagnosed among Black men in 2022,accounting for 37%of all new cancers in Black men.Approximately 1 in 6 Black men will be diagnosed with prostate cancer in his lifetime compared to 1 in 8 White men.During 2014-2018,the average annual prostate cancer incidence rate was 172.6 case
165、s per 100,000 Black men,73%higher than the rate in White men(Table 5).Similar to White men,incidence rates in Black men increased sharply from 1989 to 1992,then declined until the early 2010s,reflecting changes in use of the prostate-specific antigen(PSA)blood test.Rates were stable in Black and Whi
166、te men from 2014 through 2018,although this trend reflects localized-stage disease,which accounts for the majority of cases;rates for regional-and distant-stage disease increased during this time period by about 5%per year in Black and White men.The upturn in advanced disease likely reflects the red
167、uction in screening following the US Preventive Services Task Force(USPSTF)2012 recommendation against routine PSA testing.131 In 2018 the USPSTF revised the guideline again to recommend informed decision making among men ages 55-69 years.Mortality Prostate cancer is the second-leading cause of canc
168、er death in Black men,with an estimated 6,040 deaths expected in 2022.Black men have the highest death rate for prostate cancer of any racial or ethnic group in the US,2 times higher than White men(Table 6).Although there is some evidence that aggressive prostate cancer is more common in Black men,1
169、32,133 the larger disparity for mortality than incidence largely reflects less access to high-quality treatment.134,135 The prostate cancer death rate in Black men has dropped by more than 50%,from a peak of 82.1 deaths per 100,000 in 1993 to 36.6 deaths per 100,000 in 2019,similar to the decline am
170、ong White men.Factors that have likely contributed to the decrease include early detection through PSA testing,improved surgical and radiologic treatment,and the use of hormonal therapy for advanced-stage disease.136-140 However,rapid declines since the mid-1990s have slowed in recent years,likely r
171、eflecting the uptick in advanced disease.131 From 2015 to 2019,the death rate declined by 1.3%per year among Black men and by 0.7%per year among White men(Figure 3).131 20 Cancer Facts&Figures for African American/Black People 2022-2024Studies continue to document that Black men are relatively more
172、likely to receive substandard treatment for prostate cancer.132,141-143 Recently,it was reported that Black men diagnosed with advanced-stage prostate cancer were significantly less likely to receive any treatment compared to White men,even when accounting for similar insurance.144 When treatment is
173、 similar,prostate cancer 10-year survival is comparable135 or even higher among Black men.134,135 Prevention and Early Detection The strongest known risk factors for prostate cancer are a family history of the disease,African ancestry,145 and certain inherited genetic conditions(e.g.,Lynch syndrome
174、and BRCA1 and BRCA2).146,147 Smoking and excess body weight may increase risk of aggressive/and or fatal disease.148-152 Prostate cancer usually has no symptoms until disease is advanced,but is a good candidate for early detection through screening because it is usually slow-growing.No organization
175、presently endorses routine screening with the PSA test for men at average risk because of concerns about overdiagnosis(detection of disease that would never have caused harm)and serious treatment-related side effects.However,a recent modeling study estimated that screening Black men 45-69 years of a
176、ge could reduce mortality by 26%-29%while limiting overdiagnosis.153 The USPSTF recommends that men ages 55-69 discuss the benefits of screening with their health care providers and make informed decisions based on family history,race/ethnicity,and comorbidities.The American Cancer Society similarly
177、 recommends informed decision-making beginning at age 45 for Black men and age 50 for other men.For more information on PSA testing,see page 33.Survival and Stage Distribution The overall 5-year relative survival rate for prostate cancer is 96%for Black men and 98%for White men(Figure 5).Eighty-four
178、 percent of all prostate cancers among Black men are diagnosed at a local or regional stage,for which the 5-year relative survival rate approaches 100%.When prostate cancer is diagnosed at a distant stage,5-year survival drops to 30%in both Black and White men.Stomach Incidence An estimated 4,510 ca
179、ses of stomach cancer are expected to be diagnosed in Black men and women in 2022.Stomach cancer incidence is about 2 times higher in Black men and women than White men and women(Table 5).However,higher rates are limited to cancers in the lower stomach,or non-cardia,whereas rates for cardia tumors,i
180、n the upper stomach near the esophagus,are similar by race.154 From 2009-2018,stomach cancer incidence rates declined more steeply in Black people(2%per year)than in White people(1%per year).Mortality Approximately 1,830 deaths from stomach cancer are expected to occur among Black people in 2022.Sto
181、mach cancer death rates are more than 2-fold higher in Black than White people,only in part due to higher incidence.The racial disparity in mortality is greater for men than for women,whereas the reverse is true for incidence(Table 5 and Table 6).During 2010-2019,stomach cancer death rates declined
182、in Black men and women by 3%per year,similar to declines in White people.Prevention Helicobacter(H.)pylori infection is the most important risk factor for stomach cancer and is more than three times more common in Black than White people.155 For more information on H.pylori,see page 30.Other risk fa
183、ctors for stomach cancer include excess body weight(cardia cancer),smoking,high consumption of grilled and salt-preserved meat,and occupational exposures such as coal,rubber,and metal processing.156,157 Survival and Stage Distribution Overall,5-year relative survival for stomach cancer in Black peop
184、le is 32%,comparable to that in White people(Figure 4).However,5-year relative survival for non-cardia tumors,which account for more than half(55%)of cases in Black people but only 34%in White people,is 36%in Black people versus 44%in White people.Five-year relative survival rates for cardia tumors,
185、which are less amenable to surgical treatment,are similar in Black and Cancer Facts&Figures for African American/Black People 2022-2024 21White people(23%verus 24%,respectively).Similar to other cancers,research suggests that Black patients with stomach cancer are less likely to receive appropriate
186、surgical treatment than White patients.158 Nearly 1 in 3 Black stomach cancer patients are diagnosed with distant-stage disease,including 40%for cardia and 30%for non-cardia,for which the 5-year relative survival rate is 5%for both cardia and non-cardia.Uterine Cervix Incidence In 2022,an estimated
187、2,460 cases of invasive cervical cancer are expected to be diagnosed among Black women.The incidence rate of cervical cancer is 22%higher in Black women than in White women(Table 5).However,the disparity is much wider when rates exclude women who cannot develop cervical cancer because of a hysterect
188、omy(removal of uterus and cervix),a procedure more common in Black women.159 One study found that after correcting for hysterectomy,incidence for cervical cancer was approximately 40%higher in Black than White women.160 From 2009-2018,cervical cancer incidence rates among Black and White women were
189、stable.Mortality An estimated 780 deaths from cervical cancer are expected among Black women in 2022.Mostly as a result of screening,cervical cancer death rates have declined steadily since the 1970s(Figure 6b);rates in Black women continued to decline by 2%per year from 2010 through 2019,but have s
190、tabilized in White women in recent years.Despite this progress,Black women remain 65%more likely to die from cervical cancer than White women(Table 6),with an even larger disparity after rates are corrected for hysterectomy prevalence.159 Prevention and Early Detection Cervical cancer is caused by p
191、ersistent infection with certain types of human papillomavirus(HPV)and is highly preventable through screening and vaccination.It is one of only two cancers(colorectal is the other)that can be prevented through screening.Most cervical abnormalities are detected as preinvasive lesions rather than inv
192、asive cancers because of the widespread uptake of screening with the Pap test and more recently the HPV test.For more information on cervical cancer screening and HPV prevention,see page 32 and page 29,respectively.Survival and Stage Distribution The overall 5-year relative survival rate for cervica
193、l cancer among Black women is 56%,compared to 67%among White women,partly because Black women are more likely to be diagnosed with regional-or distant-stage disease(Figure 4).Racial differences in stage at diagnosis may be due to differences in the quality of screening and/or follow-up after abnorma
194、l results.161-165 However,Black women have lower survival than White women for every stage of diagnosis(Figure 5),likely reflecting disparities in access to care and receipt of high-quality treatment.For example,one study found that among people diagnosed with early-stage disease,17%of Black women d
195、id not receive surgery compared to just 9%of White women.166 Further,Black women are less likely to receive recommended radiation therapy for every stage of disease.167 Uterine Corpus(Endometrial)Incidence An estimated 9,030 cases of cancer of the uterine corpus(body of the uterus)will be diagnosed
196、in Black women in 2022.Cancer of the uterine corpus is often referred to as endometrial cancer because more than 90%of cases occur in the endometrium(lining of the uterine corpus).The uterine cancer incidence rate in Black women(28.1 per 100,0000)is similar to that in White women(27.8 per 100,000)wi
197、thout correction for hysterectomy prevalence(Table 5).However,hysterectomy correction results in an 80%increase in the rate for Black women versus a 58%increase for White women,168 equating to a 15%to 20%higher rate among Black women.Historically,endometrial cancer incidence rates have been lower in
198、 Black then White women but a steeper and earlier increasing trend,beginning in the mid-1990s,has led to the recent convergence of rates.Increased risk may be related to the obesity epidemic,although a subtype that is less strongly associated with obesity appears to be driving the trend.168 From 201
199、4 to 2018,incidence rates 22 Cancer Facts&Figures for African American/Black People 2022-2024increased by about 2%per year in Black women but appeared to stabilize in White women.Mortality In 2022,an estimated 2,680 deaths from uterine corpus cancer will occur among Black women.The uterine corpus ca
200、ncer death rate in Black women is nearly double that in White women(9.0 versus 4.6 deaths per 100,000,respectively;Table 6),likely due to unequal access to high-quality treatment.From 2010 to 2019,the death rate increased by about 2%per year in Black women,similar to increases in White women.Prevent
201、ion and Early Detection An estimated 71%of all uterine corpus cancers are attributable to modifiable risk factors;excess weight alone is associated with 60%of all cases.5 Other risk factors include the use of postmenopausal estrogen(estrogen plus progestin does not appear to increase risk)and Tamoxi
202、fen,a drug used to prevent and treat breast cancer that increases risk slightly.Pregnancy and use of oral contraceptives or intrauterine devices are associated with reduced risk.Although there is no recommended screening test for women at average risk,early signs of disease include bleeding between
203、periods and postmenopausal bleeding.Women are encouraged to report any unexpected bleeding or spotting to their physicians.Survival and Stage Distribution The Black-White disparity in 5-year relative survival for uterine corpus cancer is among the largest of any cancer:63%in Black women compared to
204、84%in White women.Later-stage diagnosis,more aggressive tumors,and lower likelihood of timely optimal treatment contribute to the disparity.169,170 Close to half(44%)of uterine corpus cancers in Black women are diagnosed at an advanced stage or are unstaged(usually advanced)compared to 29%in White w
205、omen(Figure 4).Survival is lower for Black women for every stage of diagnosis,with the largest difference for regional-stage disease(52%versus 72%;Figure 5).This may partly reflect a higher prevalence of aggressive uterine cancer subtypes(e.g.,uterine serous cancer,uterine carcinosarcoma).168,171,17
206、2 Risk Factors for Cancer The American Cancer Society estimates that 42%of all cancer cases and 45%of cancer deaths in the US are attributed to potentially modifiable risk factors,including cigarette smoking,excess body weight,alcohol intake,poor diet,physical inactivity,and exposure to cancer-assoc
207、iated infectious agents.5 This section provides information about major cancer risk factors and their prevalence among Black people in the US.It is critical to recognize that social,economic,and cultural factors,as well as policy,can influence health-related behaviors,and although these choices are
208、made by individuals,they are largely influenced by the communities and environments in which people live.For information about cancer risk factors beyond what is included in this section,visit cancer.org/statistics to review the most recent edition of Cancer Prevention&Early Detection Facts&Figures.
209、Tobacco Cigarette Smoking Tobacco use remains the most preventable cause of death in the US,increasing risk for at least 12 cancers:oral cavity and pharynx,larynx,lung,esophagus,pancreas,uterine cervix,kidney,bladder,stomach,colorectum,liver,and acute myeloid leukemia.173 Cigarette smoking may also
210、increase risk of fatal prostate cancer and a rare type of ovarian cancer,150,173,174 and is estimated to cause about 30%of all cancer deaths in the US.5 Black communities are particularly at risk due to a history of targeted ads,specifically for menthol cigarettes.Tobacco-related cancer mortality is
211、 higher among Black people than White people because of historically higher smoking prevalence,but is also declining more rapidly because of steeper reductions in smoking initiation.109,175 Cancer Facts&Figures for African American/Black People 2022-2024 23 Historically,smoking prevalence was marked
212、ly higher in Black men compared to White men,but differences have narrowed during the past 20 years(Figure 8);in 2019,18%of Black men currently smoked compared to 16%of White men.Historically,Black and White women had similar smoking prevalence,but since about 1990 rates have been lower in Black wom
213、en(Figure 8);176 in 2019,13%of Black women currently smoked cigarettes compared to 16%of White women.Among adults who smoked in 2018,the rate of successful cessation in the past year was lower among Black(5%)than White(8%)people,even though Black people attempted to quit at higher levels(62%versus 5
214、3%).This inconsistency may reflect unequal access to cessation medications.177 In 2020,3%of Black high school students reported current cigarette use compared to 5%of White high school students(Figure 9).Among Black people who smoke,more than 80%use menthol cigarettes compared to about 30%of White p
215、eople,178 likely because of targeted marketing of menthol products in Black communities.179 Menthol may increase cigarette and cigar initiation and nicotine dependence among youth and young adults and make quitting more difficult.180-182 Other Combustible Tobacco Products People who smoke cigars hav
216、e an increased risk of cancers of the lung,oral cavity,larynx,and esophagus compared to people who do not smoke cigars.183-185 Cigars,including little cigars or cigarillos,cost less than cigarettes;are often sold as singles and include flavorings;and are disproportionately marketed in Black communit
217、ies.186 Waterpipes heat tobacco(often flavored)and smoke is passed through water,a process that cools the smoke and enables deeper inhalation among novice smokers.Although many individuals perceive waterpipe smoking to be less harmful than cigarettes because it is done in social settings(e.g.,hookah
218、 bars),this form of tobacco use is known to increase the risk of lung,oral,and esophageal cancers,as well as noncancer respiratory illnesses.187-189 Cigar,cigarillo,or filtered little cigar smoking prevalence in Black adults ages 18 years was 2 to 3 times higher than among White adults in the past d
219、ecade,190 but the gap appears to be narrowing(2019:5%in Black people;4%in White people)(Figure 9).Over the past decade,cigar,cigarillo,or little cigar smoking prevalence was consistently higher in Black students(9%in 2020)than in White(4%)or Hispanic(6%)students(Figure 9).191 While regular pipe,wate
220、rpipe,or hookah smoking is similar in Black and White adults(1%),Black high school students(4%)report a higher prevalence of hookah use than White(2%)students(Figure 9).E-cigarettes(Vaping Devices)E-cigarettes,which emerged in the mid-to-late 2000s,are devices that aerosolize a liquid nicotine solut
221、ion.Although evidence suggests that switching completely from conventional to e-cigarettes reduces exposure to numerous toxins and carcinogens,192 there is accumulating Figure 8.Adult Cigarette Smoking Prevalence(%)by Sex and Race,US,1965-2019YearPercentBlack maleWhite maleWhite femaleBlack female01
222、0203040506020000501965Race includes Hispanic ethnicity.Due to changes in NHIS survey design,2019 estimates are not directly comparable to prior years and are separated from the trend line.Sources:1965-2015:Health,United States,2016.2016-2019:National Health Interview
223、 Surveys,2016-2019.2022,American Cancer Society,Inc.,Surveillance and Health Equity Science 24 Cancer Facts&Figures for African American/Black People 2022-2024evidence of negative short-term effects on airways and blood vessels.193,194 However,because these products are relatively new,risks associat
224、ed with long-term use are unknown.192,195 Adolescent and young adult e-cigarette users are more likely than non-users to begin using combustible tobacco products.196,197 In 2019,4%of Black adults were current e-cigarette users compared to 6%of White adults(Figure 9).E-cigarettes,alongside cigars,wer
225、e the most commonly used tobacco product among Black high school students(9%)in 2020,although use was lower than among White(23%)or Hispanic(19%)students(Figure 9).191 Secondhand Smoke About 3%of all lung cancer cases in the US can be attributed to secondhand smoke exposure.5 Approximately 42%of Bla
226、ck nonsmoking people ages 20 years have serum markers for secondhand smoke compared to just 18%of White people.198 Secondhand smoke exposure is even higher among youth;57%-58%of Black youth ages 3-17 had evidence of exposure compared to 36%-41%of White youth in 2017-2018.199 Excess Body Weight,Alcoh
227、ol,Diet,and Physical Activity Aside from avoiding tobacco use,maintaining a healthy weight and limiting alcohol consumption are among the most effective strategies for reducing cancer risk.200 An estimated 18%of all cancers can be attributed to the combined effects of excess body weight,alcohol cons
228、umption,physical inactivity,and an unhealthy diet.5 The American Cancer Societys 2020 diet and physical activity guideline provides recommendations to help individuals adopt healthy benefits.200 Those who most closely follow these recommendations are 10%-20%less likely to be diagnosed with cancer an
229、d 25%less likely to die from cancer.201 Community action strategies are also included in the guideline because of strong environmental influence on individual food and activity behaviors.Excess Body Weight An estimated 5%of all cancer cases in men and 11%in women can be attributed to excess body wei
230、ght.5 Excess body weight(overweight or obesity)increases risk for many cancers:uterine corpus(endometrium),esophagus(adenocarcinoma),liver,stomach(cardia),kidney (renal cell),meningioma,multiple myeloma,pancreas,colorectum,gallbladder,ovary,female breast(post-menopausal),and thyroid.121 Although the
231、 evidence is less Figure 9.Current*Cigarette Smoking Prevalence(%)by Sex and Race/Ethnicity,US,2019-2020Adults,18+yearsHigh school studentsPercent0510152025Pipe/Water PipeSmokelessTobaccoCigarettesCigarsE-cigarettes0510152025WaterpipeCigarettesCigarsE-cigarettes*Adults:Ever smoked 100 cigarettes in
232、lifetime and smoking every day or some days at time of survey.High school students:Smoked on at least 1 day out of the 30 days preceding the survey.Note:Race is exclusive of Hispanic ethnicity.Adult estimates are age adjusted to the 2000 US standard population.Sources:Adults:National Health Intervie
233、w Survey,2019.High school students:National Youth Tobacco Survey,2020.2022,American Cancer Society,Inc.,Surveillance and Health Equity Science BlackWhite23944952346541615411=30 kg/m2.Estimates for adults are age adjusted to 2000 US standard population.Sources:National Health and Nutrition Examinatio
234、n Surverys,2017-2018.2022,American Cancer Society,Inc.,Surveillance and Health Equity Science00708090100WhiteBlackWhiteBlackWhiteBlackWhiteBlackWhiteBlackWhiteBlackWhiteBlackWhiteBlackOverweightObese313123269*12172014*491113124145Figure 10.Trends in Obesit
235、y*Prevalence(%),Adults 20-74 Years,by Sex and Race/Ethnicity,US,1976-2018YearPercentNote:Race is exclusive of Hispanic ethnicity.*Body mass index=30.0 kg/m2.Notes:Estimates are age adjusted to the 2000 US standard population.Sources:1976-2010:Health,United States,2013.2011-2018:National Health and N
236、utrition Examination Surveys,2011-2018.2022,American Cancer Society,Inc.,Surveillance and Health Equity ScienceBlack femalesBlack malesWhite femalesWhite males00-20-20-20-20-20-19941976-1980 Cancer F
237、acts&Figures for African American/Black People 2022-2024 27Figure 12.Prevalence of Obesity*(%),Adults 18 Years and Older,2017-2019ALAZARCACOCTDEFLGAIDILINIAKSKYLAMEMDMAMNMSMOMTNENVNHNJNMNYNCNDOHOKORPARISCSDTNTXUTVTVAWAWVWIWYDCAKHINon-Hispanic BlackALAZARCACOCTDEFLGAIDILINIAKSKYLAMEMDMAMIMNMSMOMTNENV
238、NHNJNMNYNCNDOHOKORPARISCSDTNTXUTVTVAWAWVWIWYDCAKHINon-Hispanic WhiteNote:Race is exclusive of Hispanic ethnicity.*BMI=30 kg/m2Source:Centers for Disease Control and Prevention,2021.2022,American Cancer Society,Inc.,Surveillance and Health Equity ScienceMILess than 20%20%-24.9%25%-29.9%30%-34.9%35%-3
239、9.9%40%or moreInsufficient dataLess than 20%20%-24.9%25%-29.9%30%-34.9%35%-39.9%40%or moreInsufficient data 28 Cancer Facts&Figures for African American/Black People 2022-2024Diet An estimated 4%-5%of cancer cases can be attributed to poor diet.5 Diet patterns high in processed and red meat,starchy
240、foods,refined carbohydrates,and sugary drinks are associated with higher risk of developing cancer(predominately colon).216 Conversely,dietary patterns emphasizing a variety of fruits and vegetables,whole grains,legumes,and fish or poultry and few red and processed meats are associated with lower ca
241、ncer risk.217,218 Diet is also influenced by access to healthy food,which is influenced by socioeconomic and community factors.12,14,210 Among Black adults in 2019,10%consumed three or more servings of vegetables per day and 24%reported eating two or more servings of fruits daily,somewhat lower than
242、 that for White adults(Table 7).Among Black high school students in 2019,about 12%consumed vegetables three or more times per day and 27%consumed fruit/100%fruit juices two or more times per day,similar to that among White students(Table 7).Overall dietary patterns as measured by the Healthy Eating
243、Index(HEI)between 1999 and 2016 showed no improvements among Black people.219 Between 1999 and 2018,total energy consumed from ultra-processed foods among youth ages 2-19 years increased more in Black than White youth.220 Consumption of“fast food”on any given day was higher among Black(42%)than Whit
244、e(37%)adults in 2013-2016 and in Black(17%)than White(13%)youth in 2015-2018.221 Despite a decrease in prevalence of sugar-sweetened beverage consumption in youth and adults overall between 2003-2018,222 Black adults contributed more to total consumption in 2015-2018 than White adults(15%versus 9%).
245、223 Physical Activity Physical activity decreases the risk of cancers of the colon(but not rectum),female breast,endometrium,kidney,bladder,esophagus(adenocarcinoma),stomach(cardia),and possibly lung.224-226 Approximately 3%of cancer cases can be attributed to lack of physical activity,although Tabl
246、e 7.Health Risk Prevalence(%),Adults and High School Students,by Sex and Race/Ethnicity,US 2018-2019BlackWhite No leisure-time physical activityAdults(18 yrs)All3422Males2720Females4123High School Students*All2613Males2211Females3115Met recommended levels of aerobic activityAdults(=18 yrs)*All4758Ma
247、les5461Females4155High School Students*All2126Males2935Females1316Alcohol consumptionAdults(Heavy Consumption,=18 yrs)All37Males36Females37High School StudentsAll1734Males1533Females1936Consumed 2 fruit servings a dayAdults(=18 yrs)All2426Males2223Females2729High School StudentsAll2728Males3029Femal
248、es2426Consumed 3 vegetable servings a dayAdults(=18 yrs)All1013Males911Females1216High School StudentsAll1214Males1314Females1113Races are exclusive of Hispanic ethnicity.Estimates for adults are age adjusted to the 2000 standard US population.*Not physically active for a total of at least 60 minute
249、s on at least 1 day out of the past week.*Includes 150 minutes of moderate-intensity activity or 75 minutes of vigorous-intensity activity each week.*Were physically active at least 60 minutes per day on all 7 days prior to survey.Men:14 drinks per week,women:7 drinks per week.At least one drink of
250、alcohol,on at least 1 day during the 30 days before the survey.Source:Adults Physical Activity and Alcohol consumption:National Health Interview Survey,2018.Adults Fruit and Vegetable consumption:Behavioral Risk Factor Surveillance System,2019.Youth Youth Risk Behaviour Surveillance System,2019.2022
251、,American Cancer Society,Inc.,Surveillance and Health Equity ScienceCancer Facts&Figures for African American/Black People 2022-2024 29this is likely an underestimate because it is only based on colon,female breast,and endometrial cancers.5 Conversely,people with cancer who are physically active are
252、 less likely to have adverse effects and to die from the disease than those who are inactive.227 Extended leisure-time sitting has also been associated with increased risk of cancer death,228 whereas replacing sedentary time with even short durations of moderate to vigorous physical activity appears
253、 to reduce cancer mortality.229 In 2018,Black adults reported no leisure-time physical activity more often than White adults (34%versus 22%,Table 7).Similarly,47%of Black adults reported meeting recommended levels of aerobic activity compared to 58%of White adults(Table 7).Racial disparities in phys
254、ical activity were larger among women than among men(Table 7).In 2015-2018,the prevalence of physical inactivity was 30%or higher in 23 states among Black adults versus only 5 states among White adults.230 Black high school girls(31%)and boys(22%)were twice as likely to report no physical activity c
255、ompared to White girls(15%)and boys(11%)(Table 7).In 2019,21%of Black high school students reported at least 60 minutes of daily physical activity in comparison to 26%of White high school students(Table 7).Type 2 Diabetes Type 2 diabetes is a chronic condition in which the body loses the ability to
256、respond to insulin and shares several modifiable risk factors with cancer,including excess body weight,poor diet,and lack of physical activity.Evidence suggests that type 2 diabetes may independently increase risk for several cancers,including liver,endometrium,pancreas,colorectum,kidney,bladder,bre
257、ast,and ovary.231-233 In 2017-2018,the prevalence of diabetes among Black adults(12%)was greater than that among White adults(8%).234 Although body weight differences contribute to this disparity,Black people have a higher prevalence of both diabetes and prediabetes than White people at lower body w
258、eights,suggesting that mechanisms other than obesity are involved.235 In 2019,Black people were twice as likely to die from diabetes as their White counterparts(38.3 versus 19.0 per 100,000).Infectious Agents About 3%of all cancers in the US are due to infections caused by agents such as human papil
259、lomavirus,Helicobacter pylori,and hepatitis B and C viruses.5 Fortunately,there are opportunities to prevent or treat most of these infections.Human Papillomavirus(HPV)HPV is the most common sexually transmitted disease in the US,with approximately 13 million people newly infected in 2018.236 Althou
260、gh most HPV infections are cleared by the body and do not cause cancer,virtually all cervical and anal cancers are caused by persistent HPV infection,as well as 70%of oropharyngeal cancers and 60%-70%of vaginal,vulvar,and penile cancers.237 Cervical cancer is the most common HPV-related cancer in wo
261、men,and oropharyngeal cancer is the most common in men.The virus is spread primarily through direct sexual contact and is usually asymptomatic.While there are more than 100 different types of HPV,only about 14 of these cause cancer.238 The HPV vaccine currently used in the US protects against 9 HPV
262、types and has the potential to avert 90%of HPV-associated cancers.237 The American Cancer Societys 2020 guideline recommends routine HPV vaccination of both girls and boys between 9-12 years of age(see sidebar,page 30).239 However,because vaccination does not prevent established infections from prog
263、ressing to cancer or protect against all HPV subtypes,all women should receive cervical cancer screening according to recommendations,regardless of vaccination status.(For more information about cervical cancer screening,see page 32.)In 2013-2016,the prevalence of high-risk oral HPV was similar amon
264、g Black(5%)and White(4%)adults,but prevalence of high-risk genital HPV was much higher in Black(39%)than White(22%)people.There is some evidence of variations in the prevalence of specific HPV genotypes in Black compared to White women.240 30 Cancer Facts&Figures for African American/Black People 20
265、22-2024 In 2019,slightly over half of Black girls(53%)and boys(55%)ages 13-17 were up to date with HPV vaccination,similar to coverage among White girls but higher than White boys(49%)(Table 8).Helicobacter Pylori(H.Pylori)Chronic infection with H.pylori,a bacterium that grows in the stomach and cau
266、ses damage to the stomach lining,increases risk of adenocarcinoma of the stomach,the most common type of stomach cancer,as well as lymphoma of the stomach.241 In the US,about 65%of non-cardia gastric cancers(cancers in the lower part of the stomach)and 31%of all stomach cancers are attributable to H
267、.pylori infection.5 H.pylori is thought to spread from person to person through fecal-oral and oral-oral routes and is facilitated by crowded living conditions and poor sanitation.The prevalence of H.pylori infection in the US is about twice as high in Black than White adults,with increased odds of
268、infection associated with African ancestry.242,243 Hepatitis B Virus(HBV)and Hepatitis C Virus(HCV)Chronic infection with HBV or HCV increases risk of liver cancer and non-Hodgkin lymphoma.244-246 HBV:About 7%of all liver cancers in the US are attributable to HBV,a virus that is transmitted through
269、blood or mucosal contact with infectious blood or body fluids(e.g.,semen,saliva).5 Most new HBV infections occur in unvaccinated adults with high-risk behaviors,such as injection drug use and multiple sex partners.247 HBV can also be passed from an infected mother to her child during childbirth.Amer
270、ican Cancer Society Recommendations for HPV Vaccine Use HPV vaccination works best when given to girls and boys between ages 9 and 12 years.Teenagers and young adults ages 13 through 26 years who have not been vaccinated or who have not received all of their shots should get the vaccine as soon as p
271、ossible.Vaccination of young adults will not prevent as many cancers as vaccination of children and teens.The American Cancer Society does not recommend HPV vaccination for people older than 26 years of age.Table 8.Prevalence(%)of HPV Vaccination(2019)and Cancer Screening(2018),USBlackWhite HPV vacc
272、ination(adolescents 13-17 years)Females 1 dose7271Up-to-date*5354Males 1 dose7266Up-to-date*5549Breast cancer screening Up-to-date(women 45+years)*6664Mammogram within the past two years(women 50-74 years)(USPSTF guidelines)7473Cervical cancer screening(women 25-65 years)Up-to-date8886Colorectal can
273、cer screening Adults 50+years 6568Males6469Females6666Adults 45+years 5758Males5859Females5757Prostate-specific antigen test(men 50+years)*Within the past year3337Races are exclusive of Hispanic ethnicity.Estimates for screening are age adjusted to the 2000 US standard population and do not distingu
274、ish between examinations for screening and diagnosis.HPV:human papilloma-virus.*According to recommendations;see sources for more information.239*Mammogram within the past year(ages 45-54 years)or past two years(ages 55 years).Pap test in the past 3 years among women 25-65 years OR Pap test and HPV
275、test within the past 5 years among women 30-65 years.For ages 45 and 50 years:FOBT/FIT,sigmoidoscopy,colonoscopy,computed tomography(CT)colonography,ORsDNA test in the past 1,5,10,5 and 3 years,respectively.For ages 50-75 years:FOBT/FIT,sigmoidoscopy,colonoscopy,computed tomography(CT)colonography,O
276、R sDNA test in the past 1,5,10,5 and 3 years,respectively,OR sigmoidoscopy in the past 10 years with FOBT/FIT in past 1 year.*Among men who have not been diagnosed with prostate cancer.Sources:Vaccination:National Immunization Survey-Teen,2019.Screening:National Health Interview Survey,2018.2022,Ame
277、rican Cancer Society,Inc.,Surveillance and Health Equity ScienceCancer Facts&Figures for African American/Black People 2022-2024 31Vaccination against HBV is the primary prevention strategy to reduce prevalence of the virus.Those who should be vaccinated include infants,youth under age 19 who have n
278、ot been vaccinated,and unvaccinated adults who are at high risk of infection(e.g.,health care workers,travelers to regions where HBV infections is endemic).247 In 2020,the US Preventive Services Task Force(USPSTF)maintained its previous screening recommendations for HBV after considering new evidenc
279、e that treating HBV infections leads to better health outcomes.Screening is recommended by the USPSTF for people who have not been vaccinated against HBV,as well as those who are at increased risk of infection because they were born in a country with high prevalence or engage in risky behaviors,such
280、 as injection drug use or unprotected sex with multiple partners,regardless of vaccination status.248 HBV infection rates have been steady since 2010.In 2019,the rate of newly reported chronic HBV infection was about 4 times higher among Black people(6.7 cases per 100,000)than White people (1.8 case
281、s per 100,000).249 HBV vaccination coverage in 2019 was 91%among Black adolescents and 94%among White adolescents.249 HCV:Nearly one-quarter of liver cancers in the US are attributable to HCV.5 HCV transmission is most common through intravenous drug use,but can also occur through needle-stick injur
282、ies in health care settings,mother-to-child transmission during birth,and less commonly through sexual contact with an infected partner.Most people with HCV will become chronically infected and remain unaware of their infection until liver disease develops.In contrast to HBV infection,there is no va
283、ccine to protect against HCV infection.In 2020,the US Preventive Services Task Force updated their guidelines recommending one-time screening among all men and women ages 18 to 79 years.250 Those who test positive for HCV are advised to begin antiviral treatment to reduce the risk of negative health
284、 effects and to be counseled on how to prevent transmission to others.251 During 2012-2016,approximately 2.4 million people in the US were living with current HCV infection.252 From 2013 through 2016,HCV prevalence was twice as high in Black(2.3%)compared to White(1.0%)adults.253 In 2017,only 18%of
285、adults born between 1945 and 1965 had ever been tested(according to guidelines at that time),with similar screening prevalence in Black and White adults.254 Human Immunodeficiency Virus(HIV)HIV infection is almost twice as common in Black people as in White people and is associated with elevated can
286、cer risk both directly and indirectly.HIV may be present in the body for a long time without showing symptoms;however,as the infection progresses and the immune system is weakened,acquired immunodeficiency syndrome(AIDS)develops.HIV is primarily transmitted through sexual intercourse and injection d
287、rug use.There are several AIDS-defining(serious illness that signals the progression of HIV-infection to AIDS)cancers,including Kaposi sarcoma,high-grade non-Hodgkin lymphoma,and cervical cancer.HIV-infected individuals are also at an increased risk of developing other cancers,including Hodgkin lymp
288、homa,some head and neck cancers,and anal and liver cancers.244 The weakened immune system,along with shared routes of transmission with other cancer-causing infectious agents(e.g.,HPV,HCV),increases the risk of cancers in this population.255 There are several primary prevention strategies for HIV,su
289、ch as practicing safe sex and using sterile needles.Among people diagnosed with HIV,antiviral medications reduce viral load and associated cancer risk.256 In 2018,the prevalence of diagnosed or undiagnosed HIV was 7 times higher in Black people compared to White people ages 13 years and older.249 HI
290、V-infected Black people are less likely to receive treatment than White people;in 2018,63 out of 100 Black individuals received treatment compared to 70 out of 100 White individuals.257 32 Cancer Facts&Figures for African American/Black People 2022-2024Cancer Screening Early detection of cancer thro
291、ugh screening reduces mortality from cancers of the colon and rectum,breast,uterine cervix,and lung.In addition to detecting cancer early,screening for colorectal and cervical cancers can prevent these cancers by identifying and removing precancerous lesions.The American Cancer Society guidelines fo
292、r the early detection of cancer are available at:https:/www.cancer.org/healthy/find-cancer-early/cancer-screening-guidelines/american-cancer-society-guidelines-for-the-early-detection-of-cancer.html.Black people generally have lower rates of cancer screening,likely related to less access to care and
293、 perhaps lower likelihood of physician recommendation and medical mistrust.42 For information on cancer screening beyond what is included in this section,please visit cancer.org/statistics to review the latest edition of Cancer Prevention&Early Detection Facts&Figures.Breast Cancer Screening Mammogr
294、aphy is a low-dose x-ray procedure that can detect breast cancer at an early stage when treatment is often less intensive and more successful.The American Cancer Society guidelines recommend that women at average risk begin screening at 45 years of age,with an option to begin at age 40;see page 49 f
295、or detailed screening recommendations.The American Cancer Society recommends that women with an elevated breast cancer risk(e.g.,those with BRCA1 or BRCA2 gene mutations or a family history)begin annual screening with magnetic resonating imaging(MRI)starting at age 30.This is especially important fo
296、r Black women,who are more likely to be diagnosed at a younger age and with more aggressive breast cancer subtypes.64 Among Black women ages 40 and older,mammography screening declined from a peak of 71%in 1999 to 65%in 2005,and has since remained relatively stable.249 In 2018,66%of Black women and
297、64%of White women ages 45 years and older reported being up to date with breast cancer screening(Table 8).However,self-reported survey data overestimate screening prevalence,particularly for Black women.258,259 Black women are less likely to have screening at high-quality facilities,82 and to have a
298、ccess to digital breast tomosynthesis screening(or 3-D mammography),which has a higher detection rate and lower recall compared to older technology(digital mammograms).260 Cervical Cancer Screening Regular use of Pap and HPV tests followed by appropriate and timely treatment can help prevent cervica
299、l cancer occurrence and death.261 In 2020,the American Cancer Society recommended that women ages 25 to 65 receive cervical cancer screening with the primary HPV test(preferred),co-testing that combines an HPV test with a Pap test,or a Pap test alone.(For more information on cervical cancer screenin
300、g guidelines,see page 49.)Cervical cancer screening prevalence declined in Black women ages 21 to 65 years from 90%in 2000 to 82%in 2015,and has since increased to 87%in 2018.249 In 2018,self-reported up-to-date cervical cancer screening prevalence among women ages 24-64 years was 88%in Black women
301、and 86%in White women(Table 8).Black women appear to be less likely to receive recommended follow-up after a positive cervical cancer screening test.262 Colorectal Cancer Screening Colorectal cancer(CRC)screening can prevent cancer through the detection and removal of precancerous growths,as well as
302、 detect cancer at an early stage when treatment is usually less intensive and more successful.The American Cancer Society recommends that colorectal cancer screening begin at age 45 for people at average risk with either a stool-based test or structural exam(e.g.,colonoscopy).(See more specific info
303、rmation on colorectal cancer screening recommendations on page 49).Cancer Facts&Figures for African American/Black People 2022-2024 33 From 2000 to 2018,colorectal cancer screening among adults ages 50 and older doubled from 32%to 65%in Black people and increased from 40%to 68%in White adults.263,26
304、4 In 2018,57%of Black adults ages 45 years and older were up to date with CRC screening,similar to prevalence in White adults(58%,Table 8).Despite similar self-reported CRC screening prevalence,Black people are more likely to receive a lower-quality colonoscopy.265 Recent research suggests that the
305、Black-White screening disparity has increased in recent years as rates continue to improve in White people(by 1%per year from 2008 to 2016)but have stabilized in Black people.90 Lung Cancer Screening Clinical trial data have shown that annual lung cancer screening with low-dose computed tomography(L
306、DCT)reduces lung cancer mortality among people with a high risk because of their smoking history.266,267 As a result of strengthened evidence in recent years for broader eligibility,in 2021 the US Preventive Services Task Force(USPSTF)lowered the recommended age to begin screening from 55 to 50 year
307、s of age and the pack-year threshold from 30 to 20 years.268 This change is intended to expand the number of Black individuals eligible to be screened because Black people develop lung cancer at younger ages and with lower smoking intensity.269 The American Cancer Society is currently updating their
308、 lung cancer screening guideline,but in the interim recommends following the guidance of the USPSTF.(See more specific screening recommendations on page 49).In 2020,approximately 7%of eligible adults received LDCT in the past year according to registry data,although self-reported rates are markedly
309、higher.270 According to self-reported data,the prevalence of LDCT in White and Black people ages 55-80 years was similar,although most Black people screened for lung cancer were older,suggesting that disparities in lung cancer screening may exist in younger populations.271 Prostate Cancer Screening
310、The American Cancer Society recommends that asymptomatic men ages 50 years and older have an opportunity to make an informed decision with their health care provider about whether to be screened for prostate cancer using the prostate-specific antigen(PSA)test.For Black men and men at high risk of pr
311、ostate cancer,the American Cancer Society recommends that these discussions begin at age 45.In 2018,the USPSTF recommended shared decision-making for PSA testing among men ages 55-69 years after recommending against routine screening in 2012.272 Among men ages 55-69 years,PSA testing declined from 4
312、8%to 37%(11%decline)between 2010-2018 among Black men and from 50%to 40%(10%decline)among White men.273 In 2018,33%of Black men ages 50 years and older received a PSA test in the past year compared to 37%of White men(Table 8).How the American Cancer Society Helps Reduce Cancer Disparities Eliminatin
313、g disparities in cancer is an overarching goal of the American Cancer Society.As we lead the fight for a world without cancer,we believe all people should have a fair and just opportunity to live a longer,healthier life free from cancer regardless of how much money they make,the color of their skin,
314、their sexual orientation,gender identity,their disability status,or where they live.34 Cancer Facts&Figures for African American/Black People 2022-2024Cancer Prevention and Early Detection One of the ways we are leading the fight is by encouraging evidence-based cancer screening for early detection.
315、We also work to promote healthy lifestyles by bringing attention to the effects of obesity,diet and physical activity,sun exposure,and tobacco and alcohol use on cancer risk.Aside from avoiding tobacco,maintaining a healthy weight and staying active throughout life,following a healthy eating pattern
316、 and avoiding or limiting alcohol consumption are among the most effective strategies for reducing cancer risk.The American Cancer Societys 2020 diet and physical activity guideline(see page 25)for cancer prevention provides recommendations to help individuals adopt healthy behaviors.Community actio
317、n strategies are also included in the guideline because of the strong environmental influence on individual food and activity choices.Furthermore,in addition to detecting cancer early,regular screening can prevent cervical and colorectal cancers by identifying and treating removable precancerous les
318、ions.Despite the promise of cancer screening and the associated reductions in mortality,not all population groups have benefited equally.The Community Health Advocates implementing Nationwide Grants for Empowerment and Equity(CHANGE)Program awards community grants to promote health equity within com
319、munities with limited income and/or insurance coverage and communities of color.Since 2011,over 600 CHANGE grants have been awarded,reaching individuals through more than 3.2 million outreach and education interactions,contributing more than 1 million breast,cervical,and colorectal cancer screenings
320、 at low or no cost,and implanting sustainable policy and system changes.In addition,we are collaborating with various partners to improve cancer outcomes among Black people through cancer prevention and early detection education and sharing of resources for people with cancer and their caregivers.Th
321、ese partnerships are critical in leveraging our mutual commitments to saving lives and reducing cancer disparities.The American Cancer Society is partnering with The Links,Inc.,to develop the Health Equity Ambassador Links(HEAL)program.We have trained almost 2,000 Links members as health equity amba
322、ssadors who deliver information in communities.With help from an Anthem Foundation grant,in 2021,The Links,Inc.,has committed to having another 500 ambassadors trained,which is expected to reach over 100,000 individuals in the next two years.The National Black Justice Coalition collaborates with the
323、 American Cancer Society and our advocacy affiliate,the American Cancer Society Cancer Action NetworkSM(ACS CAN)to reach Black LGBTQ+communities and other constituents with important messages relating to cancer prevention and early detection.The American Cancer Society is contributing to ongoing dia
324、logue and collaboration around health equity issues with Black-led social,civic,and faith organizations,including the African Methodist Episcopal Church;Alpha Kappa Alpha(AKA)Sorority,Inc.;Delta Sigma Theta Sorority,Inc.;Phi Beta Sigma Fraternity,Inc.;and Zeta Phi Beta Sorority,Inc.The American Canc
325、er Society Partnering For Life initiative works to spread awareness about cancer risk,prevention,and early detection in the Black community.More information can be found at https:/www.cancer.org/about-us/what-we-do/multicultural/partnering-for-life.html.Support for Quitting Tobacco The American Canc
326、er Society continues our long history of work to reduce tobacco use through research,education,and advocacy.Our tobacco control efforts focus on the adoption and implementation of smoke-and tobacco-free policies in all workplaces,public places,and other important venues such as multiunit residential
327、 settings.Our website,cancer.org,and 24/7 helpline provide information about the health benefits of quitting tobacco Cancer Facts&Figures for African American/Black People 2022-2024 35and resources for people who want to quit smoking or help someone else quit.In addition,were taking steps to reduce
328、tobacco-related health disparities,including among the disproportionately high percentage of smokers who also have mental health or substance use disorders.See page 38 for specific examples of successful efforts in furthering tobacco control within the Black community.Patient and Caregiver Services
329、The American Cancer Society provides people with cancer and their caregivers with resources that can help improve and even save lives,including information about cancer,transportation to treatment,lodging during treatment,and a whole host of other supportive services.Cancer Information Trained Ameri
330、can Cancer Society staff connect people to answers about a cancer diagnosis,treatment,side effects,health insurance,our programs and services,and referrals to other services at our 24/7 helpline at 1-800-227-2345.Our website,cancer.org,offers easy-to-understand,evidence-based,and accurate cancer inf
331、ormation.People with cancer and their caregivers can find detailed and reliable information about 70+types of cancer,available treatments,managing side effects,and living as a cancer survivor.Some of our cancer information is available in easy-reading formats and 12 different languages.Program and S
332、ervices Survivorship:The American Cancer Society survivorship work aims to help people adjusting to,living with,and moving beyond cancer from diagnosis through long-term survivorship to the end of life.Efforts focus on helping survivors manage their ongoing physical,psychosocial,functional,and socio
333、economic problems and engage in healthy behaviors to optimize their wellness.Our posttreatment survivorship care guidelines are designed to promote survivor health and quality of life by facilitating the delivery of high-quality,comprehensive,coordinated clinical follow-up care.Our survivorship research efforts focus on understanding the impact of cancer on survivors lives and on developing and te