Racial disparities in lung cancer incidence reversed or eliminated among young Americans
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Past trends of higher lung cancer incidence among young Black people vs. young white people have disappeared for men and reversed for women in the United States, according to retrospective study results published in JNCI Cancer Spectrum.
These trends coincided with larger decreases in smoking among Black Americans, researchers noted. However, in one exception to the patterns, lung cancer incidence rates increased among Black men born around 1977 to 1982 and remained higher than for white men born during that period.
“Our study reflects the success of national, state and local anti-tobacco public health policies and activities in the Black community despite tobacco companies’ targeted and deceptive marketing strategies,” Ahmedin Jemal, DVM, PhD, senior vice president of data science at American Cancer Society, said in a press release. “At the same time, an increase in lung cancer among Black men born around 1982 reflects the lack of strong public health policies to prevent the rise of smoking initiation in the 1990s.”
Previous studies demonstrated that lung cancer incidence between Black and white Americans aged younger than 40 years converged among women and nearly converged among men. Whether this pattern continued in contemporary young birth groups, however, remained unclear.
Jemal and colleagues analyzed 5-year, age-specific lung cancer incidence among Black and white Americans aged younger than 55 years by sex, and calculated Black-to-white incidence rate ratios (IRRs) and smoking prevalence ratios by birth group. Researchers gathered information from the National Health Interview Survey and analyzed incidence data from 1997 to 2016 and smoking data from 1970 to 2016.
Results showed 5-year age-specific lung cancer incidence decreased in successive Black and white men born since about 1947 and in women born since about 1957. Researchers observed steeper declines in Black Americans compared with white Americans.
As a result, the Black-to-white IRRs converged among men born between 1967 and 1972 and reversed among women born since 1967.
For example, Black-to-white IRRs among men aged 40 to 44 years declined from 1.92 (95% CI, 1.82-2.03) among men born around 1957 to 1.03 (95% CI, 0.93-1.13) among men born around 1972. The corresponding Black-to-white IRRs among women declined from 1.32 (95% CI, 1.24-1.4) to 0.71 (95% CI, 0.64-0.78).
Historically higher sex-specic smoking prevalence among Black Americans compared with white Americans disappeared among men and reversed among women born since about 1965.
Researchers noted higher lung cancer incidence among Black men vs. white men born between 1977 and 1982 (IRR = 1.87, 95% CI, 1.52-2.29, vs. IRR = 1.48, 95% CI, 1.28-1.71), which likely reflects a sharp increase in smoking initiation among Black adolescents in the 1990s, they wrote.
“[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 circa 1977 to 1982 is concerning and underscores the need for targeted tobacco interventions,” Jemal and colleagues wrote.
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