Health Care Disparities

Disparities in cancer rates among U.S. men may be due in part to differences in occupational exposure to carcinogens

Although cancer rates among black and white women are similar, black men in the United States have a much higher cancer incidence than white men. This racial disparity among men may be due in part to greater occupational exposure of black men to carcinogens, suggests a study supported in part by the Agency for Healthcare Research and Quality (HS11640).

The investigators identified men with cancer from eight U.S. cancer registries and matched control subjects without cancer to cancer case patients by birth year and geographic region of cancer registry. They limited analysis to non-Hodgkin's lymphoma, Hodgkin's disease, and soft-tissue sarcoma because few black men were diagnosed with other cancers.

The researchers interviewed the men with cancer about their demographics, medical history, lifestyle, and occupation, as well as specific occupational exposures associated with cancer. Across 13 occupational exposures examined, significant cancer risks related to occupation were limited to blacks. Among black men, exposure to chromium dust—a known carcinogen often encountered in the metal, printing, paint, textile, and other industries—was associated with nearly four times the risk of non-Hodgkin's lymphoma. Wood dust exposure was associated with nearly five times the risk of Hodgkin's disease and nearly four times the risk of soft-tissue sarcoma.

Black men who were exposed to pesticides and who reported working at a sawmill, pulp mill, or planing mill had nearly three-fold increases in their risk of soft-tissue sarcoma, although this risk did not reach statistical significance. No significant occupational risk factors for cancer among white men were identified. These findings suggest that black men have greater exposure to carcinogens on the job than white men. For example, a large retrospective study of U.S. chromate industry workers revealed that 41 percent of minorities had jobs involving exposure to the highest levels of chromate dust compared with only 16 percent of whites.

See "Occupational risk factors for selected cancers among African American and white men in the United States," by Nathaniel C. Briggs, M.D., M.Sc., Robert S. Levine, M.D., H. Irene Hall, Ph.D., and others, in the October 2003 American Journal of Public Health 93(10), pp. 1748-1752.

Return to Contents
Proceed to Next Article