Cancer Disparities Between D.C. Blacks and Whites Greater Than Those Nationwide

Disparities in cancer between white and black residents of Washington, D.C., are wider than those nationwide, with blacks much more likely to be diagnosed with and die from cancer than their white peers, according to a new RAND Corporation study.

"White residents of Washington, D.C., experience lower rates of cancer and cancer death than whites across the United States, while the cancer death rate for black residents is significantly higher than it is for blacks nationally," said Rebecca Anhang Price, the study's lead author and an associate policy researcher at RAND, a nonprofit research organization.

Researchers report that across the United States in 2009, overall cancer incidence was 4 percent higher among blacks than among whites. The disparity was more striking in Washington, D.C., where the overall cancer incidence among black residents was 54 percent higher than the incidence among white residents.

Nationally in 2008, the overall cancer mortality rate was 21 percent higher among blacks than among whites. That disparity was much greater in Washington, D.C., where overall cancer mortality among black District residents was 90 percent higher than mortality among white District residents.

The RAND study synthesized data on cancer outcomes among the city's residents to help inform future priority-setting by the DC Cancer Consortium, the sponsor of the report, and other entities concerned with the burden of cancer in the District, as well as local government policymaking around cancer more broadly.

Researchers point to the need to know more about differences in access to and quality of treatment for cancer to better understand disparities in cancer-related mortality.

"We know from available data that, once diagnosed with cancer, black patients in the District are more likely to begin treatment at a later stage compared to white patients," Anhang Price said. "But richer data on the trajectory of care among cancer patients in the District are lacking."

In addition to profiling cancer incidence and mortality among District residents, the study characterized health behaviors related to the risk of cancer and cancer screening rates, and analyzed the health system capacity related to cancer care in the District.

Researchers found similarity across racial and ethnic groups in screening rates for breast, cervical and prostate cancer, relatively high rates of screening for those cancers compared to rates nationally, and stability in those rates over the time period from 2003 through 2010.

Other authors of the RAND report are Racine Harris and Teague Ruder of RAND, Janice C. Blanchard of RAND and George Washington University Medical Center, and Carole Roan Gresenz of Georgetown University and RAND.

RAND Health, a division of the RAND Corporation, is the nation's largest independent health policy research program, with a broad research portfolio that focuses on health care costs, quality and public health preparedness, among other topics.