Black and American Indian/Alaska Native populations face the highest cancer death rates in the United States, according to a comprehensive new report examining cancer disparities from 2019 through 2023. The analysis reveals that differences in cancer mortality are substantially larger by education level than by race alone, indicating socioeconomic status plays a major role in driving racial disparities.
The gap is striking: overall cancer mortality rates were 143% to 192% higher among males with 12 years or less of education compared to those with 16 or more years of education. Among females, the difference ranged from 71% to 140%. Even when comparing people with the same education level, Black adults still experienced 7% to 28% higher cancer death rates than White adults among males and 2% to 43% higher among females.
Geographic location compounds these disparities. Cancer mortality rates were 21% higher in rural areas than in large metropolitan counties, with the greatest differences for lung and cervical cancers. Congressional districts with the highest cancer death rates cluster in the South and portions of the Midwest, regions that often overlap with states that have not expanded Medicaid coverage.
The report attributes these disparities to fundamental inequalities in social determinants of health, including limited access to health insurance, cancer screening, and treatment. Black and American Indian/Alaska Native populations, people with lower education levels, and rural residents generally face higher exposure to cancer risk factors while having less access to preventive care and early detection services.
See: “American Cancer Society’s Report on the Status of Cancer Disparities in the United States, 2025” (January 26, 2026)