The cancer burden of southern-born African Americans: analysis of social-geographic legacy.

Southern-born black Americans, especially those who migrated to the Northeast and Midwest, had much higher cancer mortality rates during the period 1979 to 1991 than their counterparts who were born and died outside the South. Elevated rates were apparent for the 35- to 44-year-old age group, and were highest among the elderly. The largest and most consistent differences between Southern-born and Northeastern, Midwestern, and Western-born African Americans were for cancer of the breast (female), esophagus, larynx, and lung (male), pancreas, prostate, and stomach. The combined effects of nutritional imbalances, cigarette smoking, high-risk jobs, limited access to medical screening and care, and other factors associated with poverty are suggested as etiologic factors common to the high-risk, Southern-born black population. It is also possible that the Southern-born excess of cancer deaths is at least partly an artifact of the data and the ecological level of the analysis.