MEDICINE / CANCER : Study Tells How Disease Varies Among Ethnic Groups
Black men in California are at particularly high risk of developing prostate cancer, while Chinese men are most likely to develop lung cancer, according to a new American Cancer Society report that highlights the diverse cancer risks of the state’s ethnic groups.
Prostate cancer is also the most common malignancy for male Caucasians, Hispanics and Asian Indians. But Japanese are most prone to colon cancer, Koreans to stomach cancer and Vietnamese to lung cancer.
It is a different story for women. Breast cancer is the most common malignancy in all ethnic groups surveyed as well as for women age 15 or older.
Lung cancer is the leading cause of cancer deaths for men and women.
The report, released Thursday, used state Department of Health Services data to estimate cancer cases and deaths in California for 1993. It also includes new data on the most common cancers in Asians.
For 1993, the American Cancer Society estimates that 126,060 new cancer cases will occur in California and that there will be 54,660 cancer-related deaths. While these numbers are large, previous studies have indicated that the overall rate of illness and death from cancer in California is lower than that for the nation.
The study is meant to increase public awareness of cancer and to help physicians and officials target screening and diagnosis efforts. But officials acknowledged that health care cutbacks triggered by the state budget crisis represent a major problem.
“If we fail to maintain access (to needed health care), the cancer problem will get worse,” said Dr. Cary Presant of St. Vincent Medical Center, the president-elect of the California Division of the cancer society.
The ethnic differences in cancer rates reflect a variety of factors, ranging from genetics to incidence of cigarette smoking to access to health care.
For instance, not only do black men have the highest rate of prostate cancer, but they are also more likely than whites to have their tumors diagnosed at advanced stages, when treatment is less successful, the report said.
One reason is that only about 35% of black men older than 50 have had a digital rectal exam, which is the standard screening test for prostate cancer, according to state statistics. The percentage for Hispanic men is even worse--about 25%. For whites, it is about 50%.
Presant said this simple exam is significantly underutilized. “Patients need to expect a rectal exam and demand that of their doctor,” he said.
Racial disparities in early cancer diagnosis extend to other treatable malignancies as well.
For cervical cancer, which can be diagnosed with a Pap smear, 91% of the cases in whites are diagnosed early, compared to 87% in Hispanics, 85% in blacks and 79% in Asians. For breast cancer, which can be diagnosed by breast self-exam or mammography, 65% of cases in whites and Asians are diagnosed at early stages, compared to 54% in African-Americans and 53% in Hispanics.
