Black men in the Washington metropolitan area have a 60 percent greater risk of dying of cancer than do area white men, according to a recently completed study of cancer mortality in the nation's 10 metropolitan areas with the highest concentrations of blacks.
While is has been known for some time that blacks have higher cancer death rates than whites, the new report indicates that something puzzling and unique is happening among black males in the Washington area.
The federally funded study by John P. Enterline, a biostatistician for the Cancer Coordinating Council of Metropolitan Washington, is the first to examine cancer mortality on a metropolitan area basis, rather than state-by-state or county-by-county.
Enterline found that black men in this area have higher cancer rates than their counterparts in such polluted, industrial, urban areas as Newark, N.J., Detroit and even nearby Baltimore.
While 250.2 black males per 100,000 in the population die of cancer each year in metropolitan Washington, the figure for the Baltimore area is 241.5 and Newark is only 227.9.
In contrast, 156.8 white men per 100,000 die of cancer in Washington, while the figure for Baltimore is 185.5 and for Newark 164.3. The national metropolitan average is 160.3.
Dr. Jack E. White, director of the Comprehensive Cancer Center at Howard University said blacks in Washington may face peculiar risks because they may have migrated here from areas of the South where they were exposed to cancer-causing environmental factors. "We have a migrant population," White said.
One of the puzzling aspects of the study is that despite its high cancer rates, this area is almost totally devoid of the industrial pollution and wastes often though to contribute to the risk of developing cancer.
While automobile pollution proliferates here, most cancers develop over more than 20 years, and the severe auto pollution is a more recent phenomenon here.
A possible explanation of why death rates from cancer of the esophagus are so much higher here than elsewhere in the country is the high rate of alcoholism and heavy drinking here, according to Enterline and White.
The death rate for black men is 27.9 per 100,000 or 176 percent higher than the national average for blacks, and 7.7 per 100,000 for whites, or 133 percent higher than the national average for whites.
Enterline and White say the high rate of alcoholism and heavy drinking here exists among both black and whites. Area blacks and whites, both male and female, die from cirrhosis of the liver at rates ranging from 123 to 199 percent above the national averages.
White said the Enterline study should be used as the first step in attempting to determine what is unique about black males here that contributes to their high cancer death rates.
"We want to try to identify and test air, water and some of these foods, to look at people and see what we find in their diets," White said. "There's no point in getting the statistics if we can't carry it further."
The Cancer Coordinating Council is a public infor mation arm of the joint Comprehensive Cancer Center that operates out of Howard and Georgetown universities.
White said Howard is applying to the National Cancer Institute for a grant to do case studies comparing dietary factors in cancer patients and control subjects. He said he also wants to begin a study of the fact that blacks have higher levels of pesticides stored in their fatty tissues.
Another factor that may affect cancer mortality among blacks, although not exclusively among this area's blacks, is that blacks may be in poorer health than whites and that when they incur cancer, their systems already are burdened by nonrelated diseases.
Sidney Cutler, a professor of community medicine at Georgetown and former associate director of the division of biometrics at the National Cancer Institute, said the study has outlined a "situation which I find very intriguing.
"You have two urban areas very close to one another, Baltimore and Washington. And in both areas the cancer experience for the black population, particularly among black males, indicates a very serious problem," he said.
"And both areas are very different. Baltimore is considered industrial, and Washington isn't. It's possible that there's a common geographic area of origin of black people from the South who migrated north" to this area, Cutler said.
"I don't know if this is true, but it's worth looking into," he said.
"Here we have a situation that certainly warrants investigation that has not been looked into seriously. As far as I'm concerned, this has done a better job of highlighting the cancer problem in the Washington-Baltimore area than any study I've ever seen," said Cutler, who taught Enterline and advised him on the study.
Enterline is concluding work on a study of cancer rates within the District of Columbia, examining differences in deaths that occurred in different areas of the city.