CANCER REPORT HIGHLIGHTS RACIAL DISPARITIES

Iowa’s Black population bears a high burden of cancer.

BY TOM SNEE

AFRICAN AMERICANS in Iowa are being diagnosed with cancer and dying from it at higher rates than any other group in the state. According to the 2021 Cancer in Iowa report issued by the State Health Registry of Iowa, the age-adjusted cancer mortality rate for Black Iowans is more than 25% greater than it is for white Iowans.

Report co-author Mary Charlton, associate professor of epidemiology in the College of Public Health, says that while the overall number of Black people in Iowa who get cancer is relatively low, this reflects the younger age distribution of Black people living in the state. When the numbers are adjusted for age, Black Iowans are more apt to get cancer when they’re younger, whereas white people are more likely to get it when they’re older.

Charlton says Iowa’s Black population had the highest cancer incidence rates of all racial and ethnic groups for the ages of 50 to 79, whereas white Iowans had the highest incidence rate of those older than 80.

“When examining rates by age at diagnosis, we found that in the 60- to 69-year-old age group the Black population had an age-adjusted new case rate that was 33% higher than the white population,” she says. “The cancer incidence rates became more similar in the older age groups. This shows how cancer impacts the Black population in Iowa at younger ages.”

Charlton says circumstances created by structural racism are largely responsible for the disparity. Black people have less access to health care, lower representation in clinical trials, more mistrust in the health care system, and may have historically received lower quality health care, resulting in increased mortality from diseases including cancer, heart disease, and diabetes.

George Weiner, director of the University of Iowa’s Holden Comprehensive Cancer Center, agrees those risk factors are responsible for much of the unacceptably high burden of cancer in the state’s African American community. “Some African Americans in Iowa suffer from lack of access to quality health care, cancer screening, or healthy diets while having increased rates of obesity and tobacco use,” says Weiner. “The result is an increased burden of cancer.”

Weiner says research into the causes of, and new treatments for, cancer remains vital, but so is being sure all Iowans benefit from what we already know.

“The causes of these disparities are deeply ingrained in our society, and it will take significant effort at many levels over a long period of time to address them,” he says. “If we are able to do so successfully, it will benefit all Iowans.”

CANCER, AGE & RACE

- Cancer is striking Iowa’s Black population at a much younger age compared to the white population. 74.8years the life expectancy of the Black population in Iowa VS. 79.3years the life expectancy of the white population in Iowa

- The state’s Black population has the highest cancer incidence rates of all racial/ethnic groups for those ages 50-79 years, whereas Iowa’s white population has the highest rate among those 80 and older.

- Black males have experienced the greatest decrease in cancer mortality over the past few decades rates compared to all other racial/ethnic groups in Iowa.

- Iowa’s Hispanic population has the lowest cancer incidence rates across all age groups.

- Aside from suicide and liver disease, Iowa’s Black population has the highest mortality rate in every single major cause of death, including cancer.

- Cancer mortality rates are declining for each racial/ethnic group, and the difference is narrowing between Iowa’s Black and white populations.

- Find the full 2021 Cancer in Iowa report at shri.public-health.uiowa.edu