Breast Cancer Disparities in African American Women

Breast Cancer Disparities in African American Women 

December 9, 2018  |  Blog Post

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Key Insight

“African American Women are disproportionately affected by Breast Cancer”

Breast cancer is one of the commonly diagnosed cancers, with over 12% of women experiencing it in their lifetimes [i]. Over 300,000 women were projected to be diagnosed with breast cancer and over 40,000 women were expected to die from it in 2018 [1]. Although overall breast cancer death rates have been decreasing in the last 30 years, the CDC found that 5-year survival rates for African American/black women is 10% less than other races [i, ii]. Incidences of breast cancer are higher in white women, but African American/black women have a higher mortality rate--and this gap is only increasing [iii].

NIH studies have partially attributed this disparity to the higher rates of behavioral risk factors in African American/black women [v]. Additionally, data indicates that minorities are more likely to be impacted by lack of proper social support structures, and their health is consequently affected: living in underserved areas prevents women from receiving quality and appropriate screenings and treatment [v]. Other contributing factors may include cultural differences and a lack of trust in the healthcare system [v].

African American/black women are more likely to have triple-negative breast cancer, which is more aggressive and has a worse prognosis than hormone-positive cancers, which are more common in white women [vi]. Studies have shown that social and environmental stressors that African American/black women experience such as segregation, perceived discrimination, and social isolation are associated with molecular changes causing HR- breast cancer subtypes [viii]. The NIH suggests that this biological difference may be reflected in fewer clinical trials targeted towards minority women [v].

Furthermore, African American/black women are now more likely to get regular mammography screenings than white women, yet their prognosis is still worse [iv]. A study in South Carolina found that African American/black women were more likely to adhere strictly to mammogram screening guidelines, but were still more likely to be diagnosed with late-stage breast cancer, suggesting a need for more frequent or earlier stages of screening [vi].

In St. Louis, researchers found that African American/black women diagnosed with breast cancer were more likely to lose their job and less likely to undergo immediate treatment compared to white women and that over 50% of them never receive treatment at all [vii].

As more research emerges about the causes and effects of health inequities that African American/black women with breast cancer experience, there likewise needs to be an increase in efforts to combat this imbalance. Researchers have called for more research on targeted drug therapy for triple-negative breast cancer, more interventions to improve adherence to breast cancer treatments, and more African American/black female representation in clinical trials, biobanks, and genomic testing [viii]. Additionally, there have been a number of recent efforts to improve the prognosis of African American/black women by improving access to screening and providing patient navigation programs [viii]. For more information on this important health equity topic, join us for our 9th annual Diversity, Inclusion, & Health Equity Symposium in June 2019 in Chicago.

Authors

Anne Wei

Healthcare Analyst at CHI

CitationS

i.https://www.breastcancer.org/symptoms/understand_bc/statistics

ii.https://gis.cdc.gov/Cancer/USCS/DataViz.html

iii.https://www.cancer.gov/about-cancer/understanding/disparities

iv.https://www.cancer.org/content/dam/cancer-org/research/cancer-facts-and-statistics/cancer-prevention-and-early-detection-facts-and-figures/cancer-prevention-and-early-detection-facts-and-figures-2017.pdf

v.https://www.cancer.gov/about-cancer/understanding/disparities

vi.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4705847/

viihttps://sc.edu/study/colleges_schools/socialwork/research/research_articles/gehlertarticle1.pdf

viii.http://cancerres.aacrjournals.org/content/78/4_Supplement/ES5-3.short

ix. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5764177/