title: Age at cancer diagnosis for blacks compared with whites in the United States.
abstract: BACKGROUND
  Younger ages at diagnosis for blacks compared with whites have been reported for several cancer types. However, the US black population is younger than the white population, which may bias age comparisons that do not account for the populations at risk.
  
  
  METHODS
  We analyzed Surveillance, Epidemiology, and End Results data for non-Hispanic blacks and non-Hispanic whites from 18 regions for the year 2010. We calculated crude mean ages at diagnosis among cases of 29 cancer types for whites and blacks. Separately, we calculated adjusted means that corrected for differences in population structure, which we obtained by fitting linear regression models to the ages at diagnosis with statistical weights specific to age and sex. Negative differences indicate younger ages in blacks, while positive differences indicate older ages in blacks. All statistical tests were two-sided.
  
  
  RESULTS
  Based on crude means, blacks were diagnosed at younger ages than whites for nearly every cancer type. However, adjustment for population structure shifted the comparisons toward older ages among blacks, and only six statistically significant differences of three or more years remained. Blacks were younger than whites at diagnosis for Kaposi sarcoma (-10.2 years), male soft tissue cancer (-5.6), male anal cancer (-5.5), and non-Hodgkin's lymphoma (-3.7), but older for cervical cancer (+4.7 years) and female thyroid cancer (+3.3). Smaller differences (<3 years) were present for female breast, female colon, lung, pancreas, prostate, and uterine corpus cancers (all P ≤ .001).
  
  
  CONCLUSIONS
  Most differences between blacks and whites in the age at cancer diagnosis are small. Large differences for a few cancer types may be driven by etiologic and subtype heterogeneity as well as disparities in access to care.
authors: Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, MD (HAR, EAE, RMP, MSS).Current affiliation: HAR is currently affiliated with the Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD. hilary.robbins@alumni.duke.edu.
authors: Hilary A
authors: HA
authors: Robbins
authors: Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, MD (HAR, EAE, RMP, MSS).Current affiliation: HAR is currently affiliated with the Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.
authors: Eric A
authors: EA
authors: Engels
authors: Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, MD (HAR, EAE, RMP, MSS).Current affiliation: HAR is currently affiliated with the Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.
authors: Ruth M
authors: RM
authors: Pfeiffer
authors: Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, MD (HAR, EAE, RMP, MSS).Current affiliation: HAR is currently affiliated with the Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.
authors: Meredith S
authors: MS
authors: Shiels
mesh_terms: D001741:Black or African American / Q000706:statistics & numerical data*; D000367:Age Factors; D000368:Aged; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000175:diagnosis* / Q000453:epidemiology*; D018426:SEER Program; D014481:United States / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data*
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