Lung Cancer: Why Race Matters

Black men most vulnerable to lung cancer

/ Author:  / Reviewed by: Robert Carlson, M.D

Lung cancer is the most lethal cancer in the United States. And black men are more likely to die from lung cancer than any other racial or ethnic group.

Over the past 20 years, cancer deaths in this country have been declining. Lung cancer follows the trend, but still tops the list - killing just over 228,000 Americans this year.

More people are overcome by lung cancer than die from breast, prostate, colon, liver and kidney cancers combined, according to the American Lung Association.

And the American Cancer Society tells us that more than twice as many African American men die from lung cancer as do white men.  

What can explain these disparities? Researchers believe a number of factors are to blame.

Despite the racial differences, the news for lung cancer and black men isn’t all gloomy. There are some positive trends happening.

Some of the facts

Let’s take a look at the facts.

  • Compared to white men, about 20 percent more black men are diagnosed with lung cancer every year.
  • 11 percent fewer black women are diagnosed with lung cancer than white women.
  • The 5-year survival rate among African Americans with lung cancer is 13 percent, compared to 16 percent among Caucasians.
  • Cancer statistics look at how many people per 100,000 to measure incidence. Between 2005 and 2009, lung cancer incidence among black men was 99.3 per 100,000 compared to 82.6 per 100,000 among white men.
  • During the same period, the death rates were 82.6 per 100,000 among black men and 63.5 per 100,000 among white males.

Positive trends

  • Between 2000 and 2009, lung cancer incidence among black men declined faster than among white men, falling 2.4 percent per year for blacks and 1.9 percent for white men.
  • In the same decade, lung cancer deaths decreased faster in black men than in white men – 3 percent per year versus 2.2 percent per year, respectively.
  • The differences in lung cancer deaths between black and white men has plummeted from 50 percent in 1990-1992 to 26 percent in 2005-2009.
  • There are no differences in incident rates among black and white adults 40 years and younger because fewer young blacks are smoking.
  • The numbers of African Americans between the ages of 25 and 34 who smoke has declined faster than among Caucasians.
  • Researchers predict that if these smoking trends continue, there will be no racial differences in lung cancer deaths in the next four to five decades.

Smoking still the biggest risk factor

Yes, people who have never held a cigarette to their lips are being diagnosed and dying from lung cancer - Dana Reeve, widow of the late Christopher Reeve, for example. Still, smoking tobacco remains the reason behind most of cases of lung cancer in this country.

Rates of smoking among black men are higher than among men of other races. That said, it seems that young black men are smarter than their elders – more and more are not smoking these days or never getting hooked to begin with.

Researchers believe the racial differences in lung cancer incidence and mortality might also be related to a preference for menthol cigarettes among African Americans – 84 percent compared to 24 percent among Caucasians.

The American Lung Association calls attention to intensive tobacco company marketing aimed at black Americans. Such marketing includes sponsorship of athletic, civic, cultural and entertainment organizations and events.

Men with less education often smoke more than their better educated peers. In 2008, black men over the age of 25 who had less than a high school education were 3.4 times more likely to be smokers than college-educated men.

Other key differences

Lung cancer tends to be diagnosed in African Americans in later disease stages. Earlier studies have found that even when diagnosed early on, blacks are less likely than whites to have surgery – which is the best choice for long-term survival.

Research has suggested that poorer physician-patient communication, less certainty regarding the diagnosis, other health conditions and lack of access to regular medical care all play a role in why surgery is not as common among African Americans as it is for Caucasians.

The major differences

Speaking about cancer in general, Chief Medical and Scientific Officer and Executive Vice President of the American Cancer Society, Otis Brawley, MD, said recently, “These disparities largely reflect unequal access to health care and other socioeconomic factors. While cancer death rates among African American men have been declining rapidly, they remain 33 percent higher than those among white men, evidence that more can and should be done to accelerate this progress by making sure all Americans have equal access to cancer prevention, early detection, and state-of-the-art treatments.”

This year, 13,110 African American men will learn they have lung cancer, and 9,430 black men will not be able to beat it.

Reviewed by: 
Review Date: 
February 19, 2013