BY TIM BONFIELD
The Cincinnati Enquirer
COLUMBUS -- The latest cancer statistics for Ohio continue to show a wide disparity in death rates between African Americans and whites in three leading types of cancer: lung, breast and prostate.
The findings were part of the second Ohio Cancer Symposium, held Friday at the Arthur G. James Cancer Hospital at Ohio State University.
The good news: Overall cancer mortality in Ohio has declined since 1990. The bad news: Ohio residents are still dying of cancer more frequently than national averages.
"We still have a long way to go," said Robert Indian, director of the Ohio Cancer Incidence Surveillance System. "Ohio remains in the top quartile of all states in cancer mortality."
As in the United States in general, cancer is the No. 2 cause of death in Ohio, behind heart disease. But Ohio's cancer death rate was 181.5 per 100,000 in 1996 compared with 170.8 for the United States in 1994 (the most recent national data available).
Not surprisingly, cancer death rates were higher among the poor and uneducated. Those groups tend to have less access to health care, less knowledge about prevention and early detection, engage in more risky behaviors such as smoking, and may be exposed to more cancer-causing chemicals in the environment, Mr. Indian reported. Different kinds of cancer had their own trends.
Lung cancer: The overall death rate from lung cancer -- the No. 1 cancer killer in Ohio -- is up 46 percent since 1973, and the rates are far worse for black men than any other group.
Overall, Ohio had 54 lung cancer deaths for every 100,000 residents in 1996. But for black men, the rate was nearly 107.7 compared with 74.6 for white men. For black women, the rate was 40.5 compared to 38.2 for white women.
Mr. Indian saw few signs of progress on lung cancer because smoking -- the cause of at least 80 percent of all lung cancer -- remains high in Ohio. One in four Ohio residents smokes, with rates ranging from less than 20 percent among the wealthy and college educated to more than 30 percent among people who didn't graduate from high school and make less than $20,000 a year.
Prostate cancer: The death rate for black men in Ohio from prostate cancer is 121 percent higher than for white men -- 53.7 deaths per 100,000 for black men vs. 24.3 deaths per 100,000 for white men. Past studies have indicated that black men are less likely to seek the prostate exams needed for early detection and treatment, which results in the cancer reaching advanced, harder-to-treat stages before black men seek medical care.
Breast cancer: Breast cancer death rates in Ohio still exceed national averages, and black women remain more likely to die from the disease. The death rate for black women was 33.6 per 100,000 compared to 27.4 for white women.
However, the racial difference cannot be explained by tracking which women get mammograms, because a state survey revealed that slightly more black women than white women said they got a mammogram in the past two years.
Instead, the differences in death rates may be because black women are more likely to develop breast cancer, more likely to delay seeking treatment (be it lack of insurance coverage or distrust of the medical system) or other factors.
Income and education, however, were powerful indicators of which women get mammograms. More than 81 percent of women with family incomes about $50,000 said they get regular mammograms, compared to 58 percent of those earning less than $20,000.
Meanwhile, 78 percent of college-educated women got mammograms compared with 48 percent of those who didn't finish high school.
When women were asked why they didn't get mammograms, some said they didn't know what a mammogram was, Mr. Indian said. But the No. 1 response was: "My doctor didn't tell me to."
