Why we don't include race as a risk factor

When discussing risk factors for cancer, among other health conditions, one that often comes up is race. Statistically, for many conditions–and many cancers–individuals of different races show significant disparities in diagnosis rates, stage at diagnosis, and overall outcomes. 

At Catch, we don’t include race as a factor when we assess your cancer risk. 

This is not because we’re disregarding the data. Instead, we feel that for the vast majority of cancers, disparities in both incidence and outcome can largely be explained by more targeted risk factors and social determinants of health. 

As an example, Black women are more likely than any other racial group to be diagnosed with uterine cancer,^[1] and they’re more likely to be diagnosed at an advanced stage of the cancer.^[2] Perhaps most alarming, they’re more than twice as likely to die from this cancer than any other group.^[1]  

However, recent studies have shown a huge increase in cancer risk among women who use chemical hair straighteners, particularly among women who began using the products at a young age, or have used them for a long time. One National Institutes of Health study from 2022 found the cancer risk jumped from 1.64% for women who had never used the products to 4.05% for those who used them regularly.^[3] Chemical hair straighteners are used more often by Black women than other groups, which may explain the observed increase in diagnoses, but race is not a meaningful explanation for the risk increase–exposure to a known carcinogen is. While more studies are needed to determine any specific effects these products have on morbidity, it’s well-documented that certain causes of cancer can also correlate with better or worse outcomes.

No cancer is as simple as a single risk factor, of course, but studies like this highlight how large an impact individual risk factors can have on one’s personal cancer risk. The picture becomes even more complicated when you take into account less clear-cut risk factors like diet, pre-existing health conditions, and personal choices like smoking, drinking alcohol, and using cannabis, which can also vary by race. Cancer data is regularly broken down by race, which may make it appear that race is a biological determinant of risk, but often what this data is actually capturing is higher (or lower) incidence of well-studied risk factors or protective factors that are within an individual’s control.  

It’s important to note that some risk factors may be biologically tied to race. Hemochromatosis–a genetic disease that causes iron to build up in the body--is a known risk factor for cancer, particularly liver cancer. It’s significantly more common amongst people of Northern European descent.^[4] However, the risk factor in play is not one’s race, but a disease which is more common in certain populations than others. At Catch, we ask about pre-existing conditions like hemochromatosis with a known impact on cancer risk, rather than pegging our risk model to overly broad–and ultimately uninformative–factors such as race. 

Another source of disparities in both diagnoses and outcomes is screening adherence. If a given racial group has higher rates of screening, they likely show higher diagnosis rates – but are also likely to diagnose the cancer at an earlier stage (leading to lower mortality). For lack of a better term: the data quickly becomes messy, and what’s being captured may not be an accurate reflection of true cancer rates or outcomes. 

Being empowered to take charge of your own health requires specific knowledge about your actual risks and the testing you’ll need to monitor them. It’s why we make a point not to lump Catch users into large demographic tranches–like age or race–and instead ask targeted questions based on the latest medical research. These help us assess individual risk, and tailor an individual Action Plan and Testing Protocol to meet each user’s unique needs.