African American Disparities in Breast Cancer
While breast cancer is less common in minorities, African American women may
have more reason to be concerned than whites after a diagnosis of breast cancer.
Two studies published in the Journal of Clinical Oncology highlight a racial gap
in breast cancer mortality and, while it is still unclear what role it plays in
mortality rates, one finds that minorities in general are less likely to receive
the best breast cancer treatment.
In the first study, researchers from the University of Michigan compared the
mortality rates of over 14,000 African American women and 76,000 white women
with breast cancer. After eliminating socioeconomic factors, they found that
African American women are 19 times more likely to die from breast cancer than
white women who have the same stage of cancer. This evidence disputes the common
belief that African American women have lower survival rates because they are
diagnosed later than whites.
"Much of the racial disparity in breast cancer mortality has been attributed to
later diagnosis." wrote Dr. Nina A. Bickell, associate professor of health
policy and medicine at Mount Sinai. "Yet, even within stage categories,
mortality rates are higher for minority women."
In the study, Dr. Lisa Newman suggests that biologic, genetic, cultural and
societal factors may cause higher mortality rates in African American women with
To further elucidate one possible cause for the higher mortality rates, Bickell
looked at the use of adjuvant breast cancer treatment—chemotherapy given after
surgery to kill any remaining cancer cells—in minority women with early-stage
breast cancer. Adjuvant chemotherapy greatly reduces the risk of cancer
recurrence and is considered to be the standard of care for patients after
breast cancer surgery. Comparing treatment in 677 women with breast cancer,
Bickell found that 34 percent of blacks and 23 percent of Hispanics were not
given chemotherapy after surgery as compared to only 16 percent of whites.
"Our finding highlights just how much progress could be made to eliminate cancer
death and suffering by closing the gap on racial disparities in breast cancer
treatment." said Bickell.
While her study was conducted in New York City, where there is an abundance of
care centers, Bickel believes that part of the reason minority women receive
less care is that they are less likely to have health insurance. Additionally,
these women were also found to be less likely to speak with an oncologist
concerning their care.
"Instituting a required oncology consultation may reduce racial disparities in
care." said Bickel, who further explained that better communication between
patient and doctor would also help improve care for minorities with breast