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Overall cancer death rates in the United States have declined since 1990. The decline could be accelerated by eliminating socioeconomic and racial disparities in major risk factors and screening utilization. We provide an updated review of the prevalence of modifiable cancer risk factors, screening, and vaccination for U.S. adults, focusing on differences by educational attainment and race/ethnicity. Individuals with lower educational attainment have higher prevalence of modifiable cancer risk factors and lower prevalence of screening versus their more educated counterparts. Smoking prevalence is 6-fold higher among males without a high school (HS) education than female college graduates. Nearly half of women without a college degree are obese versus about one third of college graduates. Over 50% of black and Hispanic women are obese compared with 38% of whites and 15% of Asians. Breast, cervical, and colorectal cancer screening utilization is 20% to 30% lower among those with <HS education compared with college graduates. Screening for breast, cervical, and colorectal cancers is also lower among Hispanics, Asians, and American Indians/Alaska Natives relative to whites and blacks. Enhanced, multilevel efforts are needed to further reduce the prevalence of modifiable risk factors and improve screening and vaccination, particularly among those with lower socioeconomic status and racial/ethnic minorities.
Sauer et al. (Mon,) studied this question.