Although the cancer mortality rate among Black patients in the United States has dropped over the past 30 years, this patient population may continue to experience a disproportionately elevated cancer burden compared with other patient populations, according to a recent study published by Saka et al in CA: A Cancer Journal for Clinicians.
Background
Black patients represent the third largest racial and ethnic group in the United States after White and Hispanic patients, accounting for approximately 14% of the total population in 2022. In 2025, estimates have suggested there may be 248,470 new cancer diagnoses and 73,240 cancer-related deaths among Black patients. Cancer is the second-leading cause of mortality in Black patients following cardiovascular disease.
Study Methods and Results
In this study, investigators used population-based data from the National Cancer Institute and the U.S. Centers for Disease Control and Prevention to compile the most recent trends in cancer incidence, mortality, survival, screening, and risk factors among Black patients.
The investigators found that from 1991 to 2022, the cancer mortality rate declined by 49% and 33% in Black male and female patients, respectively. However, Black patients had a twofold greater risk of mortality from multiple myeloma, prostate cancer, endometrial cancer, and gastric cancer; and a 40% to 50% higher risk of mortality from colorectal cancer, breast cancer, cervical cancer, and hepatic cancer. Similarly, the survival rates for nearly every type and stage of cancer were lower in Black patients compared with White patients. The investigators observed the largest gaps in melanoma, endometrial cancer, and cervical cancer.
“Overall declines in cancer mortality rates in Black [patients] largely reflect behavioral changes, such as historical declines in cigarette smoking among Black [adolescents], as well as advances in treatment and earlier detection for some cancers,” detailed senior study author Rebecca Siegel, MPH, Senior Scientific Director of Surveillance Research at the American Cancer Society (ACS). “Yet, this population persistently experiences a much higher mortality burden than other racial and ethnic groups for many cancers. We must reverse course,” she stressed.
Further, Black male patients experienced the most significant relative decline in cancer mortality at nearly every age from 1991 to 2022 compared with Black female patients as well as White male and female patients—including a 65% to 67% drop among those aged 40 to 59. The most commonly diagnosed cancer types continued to be prostate cancer, breast cancer, lung cancer, and colorectal cancer, at 44% among male patients, 34% among female patients, 10%, and 8%, respectively. These cancer types are predicted to account for 58% of all new cancers diagnosed among Black patients.
Black male patients had a 67% higher rate of prostate cancer incidence compared with White male patients and were more than twice as likely to die of the disease. Black female patients had a 38% higher likelihood of dying of breast cancer compared with White female patients, despite a 5% lower likelihood of being diagnosed with the disease. The rate of endometrial cancer incidence increased among Black female patients by 2% per year.
Conclusions
“This report highlights the disparities the Black community has faced for decades. While the decline in cancer mortality rates is encouraging, the stark inequities in incidence and survival for many cancers underscore the urgent need for targeted research and interventions,” emphasized Wayne A.I. Frederick, MD, MBA, Interim Chief Executive Officer of the ACS Cancer Action Network. “This is a critical opportunity for the scientific, clinical, and policy-making communities to come together to drive meaningful change. Together, we must inform strategies to close these gaps, improve early detection, and ensure equitable access to life-saving treatments for the Black community,” he added.
“Future research should not only explore the influence of systemic racism on health, but also develop mechanisms to implement change, including increasing diversity in clinical trials,” indicated William Dahut, MD, Chief Scientific Officer of the ACS. “Given this latest data, it’s also more important than ever to understand how to reduce [a patient’s] chance of getting cancer. This means taking preventative health measures, like understanding [their] risk profile, maintaining a healthy lifestyle, and keeping up on cancer screenings to catch the disease as early as possible,” he recommended.
To address ongoing cancer disparities in Black female patients, the ACS launched the VOICES of Black Women study in 2024. The study was designed to help better understand the multilevel drivers of cancer incidence, mortality, and resilience as well as those of other conditions to develop more effective strategies to address these disparities.
“While Black [patients] have disproportionately high rates for many cancers, the disparity between Black and White [female patients] for endometrial cancer is especially concerning,” underscored lead study author Anatu Saka, MPH, Associate Scientist of Cancer Surveillance Research at the ACS. “The causes behind these disparities are complex and not well understood. Initiatives like the VOICES study can help tackle this widening disparity,” she concluded.
Disclosure: For full disclosures of the study authors, visit acsjournals.onlinelibrary.wiley.com.
