Disparity of Lung Cancer Incidence Rate Between Black and White Americans Disappeared

The higher lung cancer incidence rate in young Blacks compared to young Whites in the United States has disappeared for men and reversed for women, coinciding with a decline in smoking among Black Americans, according to a study published in JNCI Cancer Spectrum.¹

While the data found the historical lung cancer incidence rate between Black and White Americans had disappeared for men and reversed for women, the incidence rate again became higher for Black men than White men born between 1977-1982.

“The historically higher lung cancer incidence rates in Blacks than Whites among young adults have disappeared in men born 1967-1972 and reversed in women born since circa 1965, which are consistent with the generational changes in smoking prevalence between Blacks and Whites by sex,” wrote the researchers.

The 5-year age-specific incidence rate decreased in successive Black and White men born since 1947 and in women born since 1957. The decreases found were steeper in Black Americans than in White Americans.

More, the Black-to-White incidence rate ratios became unity in men born between 1967-1972 and reversed in women born since 1967. Specifically, the Black-to-White incidence rate ratios in ages 40-44 born between 1957-1972 declined from 1.92 (95% CI, 1.82-2.03) to 1.03 (95% CI, 0.93-1.13) in men and from 1.32 (95% CI, 1.24-1.40) to 0.71 (95% CI, 0.64-0.78) in women.

An exception to the data is that the lung cancer incidence rates was higher for Black men than for White men born between 1977-1982.

The researchers examined 5-year age-specific lung cancer incidence rates for Black and White Americans younger than age 55. More, the Black-to-White incidence rate ratios and smoking prevalence ratios was calculated by birth cohort using nationwide data from 1997-2016 and smoking data from 1970-2016 using the National Health Interview Survey.

“Our study reflects the success of national, state, and local anti-tobacco public health policies and activities in the Black community despite the tobacco companies' targeted and deceptive marketing strategies," lead author of the study Ahmedin Jemal DVM, PhD, said in a press release.² "At the same time, the increase in lung cancer incidence among Black men born around 1982 reflects the lack of strong public health policies to prevent the rise in smoking initiation in 1990s."

The researchers cited a number of limitations for their data. One of those limitations was the inability to present incidence rates for overlapping birth cohorts narrower than 10 years because of the less frequent rate of occurrence for lung cancer in young men.

More, since cancer registries do not report data for individual-level smoking, the researchers could not directly measure the contribution of smoking to the emerging lung cancer incidence rates in Black American compared to White Americans.

“Although these patterns herald progress in reducing racial disparities in lung cancer occurrence and the success of tobacco control in the Black community, the increasing lung cancer incidence rates in Black men born circa 1977-1982 is concerning and underscores the need for targeted tobacco prevention interventions,” wrote the researchers.

References:

1. Jemal A, Miller KD, Sauer AG, et al. Changes in Black-White Difference in Lung Cancer Incidence among Young Adults. JNCI Cancer Spectrum. https://doi.org/10.1093/jncics/pkaa055.

2. Black/white disparity in lung cancer incidence reversed or eliminated among young adults [news release]. Published August 20, 2020. https://www.eurekalert.org/pub_releases/2020-08/acs-bdi081820.php. Accessed September 18, 2020.