In general, other ethnic minority groups among the U.S. population have an overall cancer incidence rate that is lower than that of white, non-Hispanic Americans. However, examination of cancer incidence by site of diagnosis and ethnic group suggests several areas of concern. All ethnic minority groups have higher rates of stomach cancer than the majority of white Americans. Korean males, for example, experience up to a fivefold increased incidence of stomach cancer compared to the majority of white Americans (Table 2-6). Similarly, disproportionate rates of cancer of the cervix are observed in many minority women (Table 2-7). For example, African-American and Hispanic women are twice as likely as white women to receive a diagnosis of cervical cancer. However, it is noteworthy that the incidence of cervical cancer among white women in Appalachian Kentucky (14.9 per 100,000) was almost twice as high as the incidence among white women and almost the same as the incidence among African-American women in the United States, according to SEER program data (Friedell, 1992). The rate of cervical cancer among Vietnamese women is an alarming 43.0 per 100,000, whereas it is 7.5 per 100,000 among U.S. white women.

Mortality Among Ethnic Minorities

Among all ethnic groups in the United States, African-American males have the highest overall rate of mortality from cancer (Miller et al., 1996; see Table 2-8). Rates of mortality from prostate cancer are notably high at two to five times higher than the level seen among other groups. Rates of mortality from lung cancer are also high among African-American males (30 percent higher than that among white males).

Examination by site of cancer and ethnic group indicates that ethnic minorities have the highest rate of mortality from stomach cancer. Rates of mortality from cancer of the cervix are also elevated among many groups of ethnic minority women (see Table 2-9). Cancer mortality rates for Native Americans were not reported because of a low incidence (fewer than 25 cases), and information on rates among Koreans and Vietnamese were also not available.

Cancer Survival Among Ethnic Minorities

Examination of survival data from the SEER program (1978 to 1981) gives a dismal picture of progress against cancer in ethnic minorities (Bacquet and Ringen, 1986). Although overall incidence and rates of mortality from cancer for many ethnic minority groups are low in comparison to those for the majority of Americans, survival from cancer is consistently poorer in these groups (Table 2-10). Today, half of all whites with cancer



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