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Black women are at an elevated risk of cancer, with specific types of the disease showing significant increases among women in their 30s.
A 2023 report by the JAMA Network highlighted a concerning trend: early-onset cases of breast, thyroid and colorectal cancer are increasing in adults under 50, especially among women in their 30s. Data from the medical journal uncovered alarming rates of these cancers emerging among young adults, prompting researchers to analyze a cohort of 562,145 individuals with early-onset cancer in the U.S. from 2010 to 2019.
Overall, early-onset cancer cases rose by 0.28% annually within this age group, with young women facing the brunt of the growing epidemic. According to the study, a notable increase in early-onset cancer cases among women occurred in 2019. In that year alone, there were 12,649 cases of early-onset breast cancer, 5,869 cases of thyroid cancer and 4,097 cases of colorectal cancer. Notably, individuals between 30 and 39 years old appeared to be disproportionately affected by the disease compared to those over 50.
While early-onset cancer growth rates remained stable in white populations and decreased somewhat among African American women between 2010 and 2019, the need for preventative cancer screening and caution remains critical, especially for those under 50. For African American women in this group, two cancers in particular are cause for concern.
Black women are disproportionately impacted by breast and colorectal cancer.
According to the American Cancer Society, Black women are 41% more likely to die from breast cancer than white women, “despite being less likely to be diagnosed” with the disease. Sadly, Black women face a three-fold risk of developing triple negative breast cancers, an aggressive form of the disease that can grow and spread more quickly, a study by Penn Medicine News noted.
Moreover, researchers revealed that triple negative breast cancers were less likely to be detected through screening and more commonly diagnosed as interval cancers compared to other subtypes.
Although thyroid cancer is relatively less prevalent among Black individuals, women within this demographic are three times more likely to develop the disease. Thyroid cancer can result in damage to the voice box and potentially spread to other areas of the body, posing significant health risks, Medicine Plus noted.
Similarly, colorectal cancer disproportionately impacts the Black community, with incidence rates ranking highest among all racial and ethnic groups in the United States. African Americans face approximately a 20% higher likelihood of developing colorectal cancer and a 40% increased risk of mortality compared to other demographic groups.
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How can Black women stay healthy?
During an interview with CNN, Dr. Otis Brawley, the Bloomberg Distinguished Professor of Oncology and Epidemiology at Johns Hopkins University, recommended that people within the impacted age group exercise regularly and try to maintain a healthy diet that consists of “five to nine servings of fruits and vegetables” a day. Lowering red meat and processed foods may also help to reduce your risk. There was no addressing of the food desserts in Black and other poor communities which often means that the only affordable food available is not fresh and is certainly processed.
Nevertheless, Brawley maintains that the alarming cancer rates in young people could be developing due to poor lifestyle habits like excessive eating, smoking and alcohol consumption.
“The largest cause of cancer in the United States right now is smoking, but smoking rates [have been] going down since the 1960s,” Brawley told CNN. “It’s in the next couple of years that the biggest cause of cancer in the United States is going to be obesity, consumption of too many calories and not enough exercise. … My gut suspicion is that a large part of this trend is lifestyle, or it’s driven by increased caloric consumption, increased obesity and not enough exercise.”
Offerings like this fail to consider larger social conditions and choices driven by those who are not Black–from the food desserts, to the depression poverty and racism trigger that contribute to the challenge it takes to self-care, to environmental racism that drives cancer rates. Addressing the issue cannot be minimized as a matter of personal failing.
For example, the doctor did not make mention of the years of study, however, that unpack why there are poorer health outcomes for Black women, including obesity. According to Boston University’s School of Public Health’s (SPH) 2023 Study, “Racism, Sexism, and the Crisis of Black Women’s Health, what is “...becoming increasingly clear [is that] racism and other stressors may be much stronger predictors of poor health than individual choices or genetic differences.”
The psychological trauma of racial discrimination may increase cortisol (the body’s stress hormone) and weaken the immune system, potentially leading to elevated blood pressure, memory problems, and other conditions.
Their 1997, 2009 and 2019 questionnaires asked participants about their past experiences with interpersonal racism, from daily, one-off encounters of perceived slights—such as poor service in a store or restaurant—to far more impactful discriminatory treatment at work or in school, with healthcare, the court system, housing, and interactions with police.
The researchers are also measuring the impact of structural racism, a relatively new term in public discourse that refers to the ways in which societies foster discrimination in policies or practices—perhaps less overt than “daily” racism, but still a reflection of the historically racist systems that remain embedded within society.
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“Structural racism affects where people live, how they can exercise, the foods they eat, and the resources available to them,” says Palmer, who is also an SPH professor of epidemiology. “We didn’t have a name for it 20 years ago, but we have always acknowledged its influence on health, and we are continuing to examine how these racial experiences uniquely affect Black women.”
Experiences of racial discrimination may lead to increased weight gain, for example, as detailed in an an earlier SPH study by Yvette Cozier, SPH’s associate dean for diversity, equity, inclusion and justice; and an associate professor of epidemiology. About 60% of Black women experience obesity compared to 40% of white women. Cozier says her findings underscore the role of racism in the U.S. obesity epidemic and the need for continued antidiscrimination efforts across the country. The researchers have also linked structural racism to increased risks of diabetes, hypertension, accelerated aging, asthma, and most recently, heart disease. It all comes down to social marginalization, including how you are received in the wider society and what you are allowed access to, including where you are forced to live and what food products you are limited.
Social Structures, Not Genes, Determine Health
A close look at the discrimination that drives racial disparities reveals another major predictor of poor health among Black women: zip code.
Historically racist policies, such as slavery, Jim Crow and redlining, have led to decades of neighborhood disinvestment in Black communities, which translates to fewer parks, fewer supermarkets with fresh and affordable foods, and higher levels of crime and air pollution. Regardless of their income or education level, Black women are still more likely to live in disadvantaged neighborhoods compared to white women.
Historically racist policies, such as slavery, Jim Crow and redlining, have led to decades of neighborhood disinvestment in Black communities.
“We’ve come to realize how much one’s neighborhood environment and social structures, rather than genes, prescribe health outcomes,” says Cozier, who now co-leads the study. She studies how psychosocial stressors—from divorce and job pressure to assault and natural disasters—influence the development of autoimmune and immune-mediated diseases, including the difficult-to-diagnose sarcoidosis, which can affect the lungs, skin, kidneys, muscles, nervous system and other organs
The doctor noted that alcohol-related cancers have also increased over the last year, which indicates that far more access to mental health services that address and help correct self-harming behavior would also contribute to physical health. But when you live in housing that tells you you’re cared for, when you’re paid less but expected to do more, when you live with the fear of no one around to protect and serve you, when you are afraid to acknowledge depression for fear of being viewed as weak—or of having your children taken away by the state–alcohol and other drugs may seem like the only relief. Society’s work must be to elevate other healthy forms of relief.
But as the long, slow process of coming to terms with structural racism unfolds, you are still powerful. Listen to your body and be aware of the symptoms for breast and colorectal cancer. According to the American Cancer Society, symptoms for both may vary, but some of the most common signs include swelling of all or part of a breast (even without a palpable lump), skin dimpling resembling an orange peel, breast or nipple pain, nipple retraction, changes in breast or nipple skin texture such as redness, dryness, flaking, or thickening, nipple discharge other than breast milk, and swollen lymph nodes under the arm or near the collarbone, which can sometimes indicate breast cancer spread even before the original tumor is large enough to be felt.
Colorectal cancer symptoms also manifest in various ways. These include changes in bowel habits like persistent diarrhea, constipation or stool narrowing lasting more than a few days, along with a sense of incomplete bowel evacuation. Rectal bleeding, often with bright red blood, and blood in the stool, which may appear dark brown or black, are also common indicators. Additionally, individuals might experience cramping or abdominal pain, weakness, fatigue and unexplained weight loss. Being mindful of these signs and promptly seeking medical attention if they arise can aid in early detection and treatment of colorectal cancer.
But as we’ve done over the centuries, we have the brilliance and strength to be part of our defense force. We deserve to live and live well. That’s the bottom line.
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