African-Americans in region face higher cancer death rates


Published: Sunday, March 24, 2013 at 6:01 a.m.
Last Modified: Saturday, March 23, 2013 at 8:25 p.m.

African-Americans in the 11 counties comprising North Central Florida have higher rates of cancer mortality than other African-Americans throughout the rest of the state, according to the North Central Florida Cancer Control Collaborative Report released in January.

“Disparities between the races are well-documented,” said Jeff Feller, CEO of the WellFlorida Council, which produced the report. “We're woefully worse off in our black population in almost every form of cancer.”

The overall age-adjusted death rate (which removes the confounding influence of age) was 234 per 100,000 people compared with 172 for Florida. The difference was most pronounced for lip, oral cavity and pharynx cancer: African-Americans in this region had a 145 percent higher death rate for these cancers compared with African-Americans in the rest of the state.

“When you look at the number of dentists and access to dentists in this area, it's very, very low. If you look at the cost of the median household, you know that these areas are very economically depressed,” said Dr. Henrietta Logan, a professor at the UF College of Dentistry and the director of the Southeast Center for Research to Reduce Disparities in Oral Health.

“That tells you that the access to the primary care is just not there.”

These cancers can be detected with a standard dental checkup (through checking for swollen lymph nodes and signs at the base of the tongue and tonsils), but lack of awareness about the cancers is fairly pervasive, Logan said.

“They've heard of lung cancer, but they don't know much about oral/pharyngeal (cancer).”

Like with lung cancer, smoking contributes to causing these cancers. The report didn't distinguish smoking habits between African-Americans and whites, but it did find that smoking rates in all counties of North Central Florida except Alachua exceeded Florida's average of 17 percent. And some counties, such as Lafayette, Hamilton and Dixie, have smoking rates that are nearly double the state average.

Apart from oral cancers, African-American men in this region have about a 10 percent higher death rate from prostate cancer compared with white men, and a slightly higher death rate among African-American men elsewhere in Florida.

“Prostate (cancer) particularly strikes African-American men hard,” Feller said. “Participation in screening programs is limited compared to whites.”

Folakemi Odedina, a UF professor of pharmaceutical outcomes and policy, added, “Not only do black men get it (prostate cancer) at an earlier age, compared to Caucasians, they also get a more aggressive form of it. The lifetime chance of surviving prostate cancer is worse for black men.”

Odedina recently received a $1.2 million Department of Defense award to conduct in-depth ethnographic research and analysis of death rates, treatment choices and coping mechanisms among black men with prostate cancer. The project aims to develop ethnically sensitive, specially targeted ways to encourage healthful behaviors.

Odedina added that for the past few years, she has been working on reaching African-American men for PSA screenings and general awareness of the disease.

“You have to get to the men where they are. Where do black men go? Barber shops, churches, clinics,” she said. “We are doing a lot more education and hopefully we will start to see the results.”

The mortality rate for breast cancer in African-American women was also higher than for whites. The higher mortality rates for breast and prostate cancer both reflect national trends, and genetics might have something to do with these.

For example, it is known that some African-American women are more predisposed to having the BRCA1 and BRCA2 mutations that feed breast cancer — as are women of Ashkenazi Jewish origin.

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