In a study reported in JAMA Oncology, Lawrence et al found that overall mortality from cancer has decreased among Black men and women in the United States between 1999 and 2019, with mortality remaining higher than that among other racial/ethnic groups. Reduced mortality among Black individuals was observed for most, but not all, cancer types.
Study Details
The serial cross-sectional study used national death certificate data from the National Center for Health Statistics and included all cancer deaths among individuals aged ≥ 20 years from January 1999 to December 2019. Trends in age-standardized mortality rates and average annual percent change (AAPC) in rates were estimated.
Key Findings
From 1999 to 2019, 1,361,663 million deaths from cancer occurred among Black individuals. The overall mortality rate decreased significantly among both Black men (AAPC = −2.6%, 95% confidence interval [CI] = −2.6% to −2.6%) and women (AAPC = −1.5%; 95% CI = −1.7% to −1.3%).
Mortality rates decreased for most cancer types, with the greatest decreases observed for lung cancer among men (AAPC = −3.8%, 95% CI = −4.0% to −3.6%) and stomach cancer among women (AAPC = −3.4%, 95% CI = −3.6% to −3.2%). The largest absolute decreases were observed for lung cancer among men (−78.5 per 100,000 population) and women (−19.5 per 100,000 population).
In this cross-sectional study, there were substantial decreases in cancer death rates among Black individuals from 1999 to 2019, but higher cancer death rates among Black men and women compared with other racial and ethnic groups persisted in 2019. Targeted interventions appear to be needed to eliminate social inequalities that contribute to Black individuals having higher cancer mortality.— Lawrence et al
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Significant increases in mortality were observed for liver cancer among men (AAPC = 3.8%, 95% CI = 3.0%–4.6%) and women (AAPC = 1.8%, 95% CI = 1.2%–2.3%) aged 65 to 79 years. Significant increases were observed for uterine cancer mortality among women aged 35 to 49 years (AAPC = 2.9%, 95% CI = 2.3%–2.6%), 50 to 64 years (AAPC = 2.3%, 95% CI = 2.0%–2.6%), and 65 to 79 years (AAPC = 1.6%, 95% CI = 1.2%–2.0%).
In 2019, the age-standardized death rates per 100,000 population for all cancers were 294.1 among Black men and 205.1 among Black women, compared with respective rates of 149.5 and 113.2 among Asians/Pacific Islanders, 255.2 and 188.5 among Native Americans/Alaska Natives, 249.0 and 181.8 among White persons, and 176.7 and 127.9 among Hispanic/Latinx persons.
The investigators concluded, “In this cross-sectional study, there were substantial decreases in cancer death rates among Black individuals from 1999 to 2019, but higher cancer death rates among Black men and women compared with other racial and ethnic groups persisted in 2019. Targeted interventions appear to be needed to eliminate social inequalities that contribute to Black individuals having higher cancer mortality.”
Wayne R. Lawrence, DrPH, of the National Cancer Institute, National Institutes of Health, is the corresponding author for the JAMA Oncology article.
Disclosure: The study was supported by the National Institutes of Health Intramural Research Program of the National Cancer Institute. For full disclosures of the study authors, visit jamanetwork.com.
