Black women and white women continue to experience racial disparities in breast cancer mortality rates, according to new figures. Sadly, it’s just one of many examples of how America’s unequal health care system has negative effects. (Read more: Why the U.S. Needs Black Female Doctors More Than Ever.)
According to a new report from the American Cancer Society (ACS) released on October 3, 2022, breast cancer mortality rates have decreased from their high in 1989, despite the fact that breast cancer is the most common type of cancer among women in the U.S. Between 1989 and 2020, the overall death rate from breast cancer decreased by 43%, which experts attribute to earlier detection through breast cancer screening, more public knowledge of the condition, and improved treatment choices.
Black women still have a 40% higher fatality rate than white women, according to the ACS, while having a 4% lower incidence rate of breast cancer overall. Despite having a lower incidence rate, American Indian/Alaska Native women also have a greater death rate than white women. Additionally, breast cancer is currently the cancer that claims the lives of the most Black and Hispanic women. Additionally, the mortality rate for Black women under 50 is twice that of White women in the same age range. (Note: Women 50 and older are most commonly affected by breast cancer.)
Unfortunately, these figures are not particularly unexpected. Rebecca Siegel, M.P.H., senior scientific director of ACS Cancer Surveillance and co-author of the paper, stated in a recent article that the gap has been reported year after year for a decade.
What’s new in the most recent ACS study, according to Eric Winer, M.D ., director of Yale Cancer Center and medical director of the Smillow Cancer Network, is simply demonstrating that the racial gap in breast cancer mortality rate hasn’t changed. And demonstrating the breadth of the disparity, especially for young Black women, he continues.
According to Dr. Winer, the overall decline in the mortality rate of women with breast cancer over the previous 30 years is “encouraging.” But I believe that the imbalance that exists for Black women, especially young Black women, is incredibly sobering and quite frankly terrifying. I would describe it as significant and unacceptable.
So why does this problem still exist? He says, “I think most of us believe that much of the challenge comes to providing treatment and making sure that it is available and effective to everyone.” And I believe that Black women don’t likely receive the same level of care as White women, which is awful.
According to Dr. Winer, there are a variety of variables that contribute to this unequal degree of and access to care. We know that education, income, and whether you have health insurance or not affect the care you receive, therefore he argues, “It’s because of socioeconomic inequalities.”
Dr. Winer states that “some of this, of course, may also be attributable to the experience of institutional racism.” The effects of racism has a very profound effect on health have been demonstrated. Therefore, even if we solved every social issue, something might have changed. For instance, Black women are statistically less likely to breastfeed after giving birth and have higher rates of diabetes, heart disease, and obesity. According to the Breast Cancer Research Foundation , each of these is a risk factor for breast cancer.
Despite the fact that young Black women are more likely than their white counterparts to develop an aggressive form of cancer (known as triple negative breast cancer ), scientists say that this is not the cause of the racial mortality rate discrepancy shown in the most recent ACS study. Dr. Winer notes that the new data demonstrates a difference in treatment results for individuals with estrogen receptor positive breast cancer. According to Siegel in the ACS report, “the variations in death rates are not explained by Black women having more severe malignancies.”
The fact that there are such large differences is unacceptable, Dr. Winer continues, as our therapy for breast cancer improves. “When there is a cure for a sickness and someone can’t obtain it, that’s just awful.”
BREST CANCER CARE: WAYS TO CLOSED THE RACE GAP To eliminate the racial disparity in breast cancer treatment, the healthcare sector as a whole is working. For instance, according to Dr. Winer, current recommendations mandate that comprehensive cancer centers in the U.S. concentrate on problems associated with these disparities in order to get financing. So, he continues, “I think nationally we are moving forward.” In addition, he adds, doctors “need to make sure that Black women with breast cancer get the same therapy that they would provide to a white woman” in addition to being aware of these data.
Even though the majority of the healthcare industry is aware of racial inequities in breast cancer care and access, more needs to be done. Health systems need to closely examine how they are treating Black women differently, according to Siegel. And it appears that Dr. Winer and his colleagues are accomplishing just that.
As the director of the cancer center at Yale, he declares, “We are really focused on this.” We are devoting a significant amount of resources to attempting to reduce the inequities in cancer care that exist in our area.
Dr. Winer advises Black women, in light of these data, to adhere to screening recommendations (the age minimum for breast cancer screening is 45), seek the finest care if diagnosed with breast cancer, and follow the recommended course of treatment if detected. Obviously, Dr. Winer admits, this is easier said than done. He remarks that institutional racism and the socioeconomic problems mentioned above make it difficult for Black women to get diagnosed and obtain the best care available, saying, “It’s obviously very problematic for many people.”
