Oncology Watch

AUGUST 10, 2011

Socioeconomic and Racial Disparities Remain in Rates of Cancer Death
The American Cancer Society’s 2011 report Cancer Statistics, published on June 17, 2011, reports a lingering inequality of cancer death rates across racial and socioeconomic groups.

The rate of cancer in African American men is 14% higher than in white men, but their risk of death from these cancers is 33% higher.

According to the report’s authors, “Compared with whites, African American men and women have poorer survival once cancer is diagnosed. The 5-year relative survival is lower in African Americans than in whites for every stage of diagnosis for nearly every cancer site.”

Smoking accounts for 30% of all cancer deaths, and the report found that for men, 53.2% of those with a high school equivalency diploma smoke, compared with 12.4% of men with a college degree and just 4.9% of men with a graduate degree. American men without a high school diploma were 2.6 times more likely to die from cancer than those with a college degree.

Obesity, which is a factor in 15% to 20% of cancer deaths, varies among women of different races. Of obese women in the United States, 42.8% are African American, 30.4% are Hispanic, and 24.7% are white. The rate of obesity declines with an increase in education (17.2% of women with graduate degrees vs 38.6% of women with a high school equivalency diploma).

Access to preventive measures against cancer deaths, such as screening, also seem to be related to socioeconomic status. Screenings for colorectal cancers, for example, occur in fewer than 20% of those without insurance, as compared with 55.7% of insured Americans. It was estimated by the report that, in 2007 alone, about 37% of cancer deaths could have been prevented by eliminating socioeconomic and racial discrepancies.

Fast Fact: A recent meta-analysis showed that green tea consumption has a statistically significant effect on reducing prostate cancer risk, even after adjusting for smoking, diet, and other factors.

Prostate Cancer Screening Timing is Key 
Since use of the prostate-specific antigen test became routine, there has been an increase in the percentage of men diagnosed with prostate cancer. This cancer mainly affects men older than 50 years, and screening typically begins at age 55 years. Men younger than 50 years only comprise about 4% of all prostate cancer patients. 

A study published July 2011 in the journal Urology showed that “Race and family history appear to play a significant role in the incidence of prostate cancer in younger men. Younger age at diagnosis is associated with more favorable outcomes and indicates the population based screening at younger ages could potentially lead to improved survival for high risk groups.” Epidemiology studies have already shown that family history of the disease and being African American put men at higher risk for this cancer.

The investigators reviewed 12,081 records of patients diagnosed with prostate cancer and stratified the patients by race, age, and decade treated. The results showed that African Americans and those with positive family history were significantly more likely to be diagnosed at an age younger than 50 years. The study also revealed that even high-risk populations showed more clinical improvements when diagnosed before age 50 years than those diagnosed later. Men diagnosed younger than age 50 years also had a lower incidence of biochemical recurrence as well as increased survival.

Cancer and Posttraumatic Stress in Families 
Does the stress of childhood cancer affect parents more than the patients? A study published in the July 2011 online edition of the Journal of Clinical Oncology found that it does. 

Lead author Tsukasa Yonemoto, MD, and colleagues administered a questionnaire to 34 families, all of which had children diagnosed with high-grade osteosarcoma, a type of bone cancer. The researchers found that “Humans show 2 contrary reactions after experiencing a mental trauma. One is a negative reaction on feeling the mental stress of the trauma, termed posttraumatic stress symptom (PTSS). The other is a positive reaction, mental growth, termed posttraumatic growth (PTG).”

The researchers measured these stress responses using the Impact of the Event Scale-Revised and the posttraumatic growth inventory (PTGI). They found that the PTSS levels tended to be higher in parents than in the osteosarcoma patients themselves, but the PTG level was found to be lower in parents than in the patients. However, parents demonstrated increased posttraumatic growth as their PTSS levels increased.

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