American Cancer Society research has found that Black women continue to have a higher mortality rate from breast cancer, although they experience the disease less frequently.
According to a study this week published in the CA: A Cancer Journal for Clinicians, the overall death rate decreased by 43% over three decades, from 1989 to 2020, resulting in 460,000 fewer breast cancer deaths.
However, black women had a lower incidence of breast cancer than White women, but their total death rate was 40% higher once the data was broken down by race.
“Death rates are declining in Black women, just like they are in almost every other group, but we’re still seeing the same gap,” said Rebecca Siegel, senior scientific director of surveillance research at the American Cancer Society.
“The evidence is consistent that Black women receive short shrift in the health care system at every point of the breast cancer care continuum from lower quality mammography to delays between the time of diagnosis and the beginning of treatment to poor quality treatment when they are diagnosed,” Siegel said. “The take-home message is that we really need to take a hard look at how we’re treating Black women differently.”
Data on breast cancer incidence and mortality from the National Cancer Institute and registries at the US Centers for Disease Control and Prevention, dating back to 1975, were examined by researchers from the American Cancer Society, Emory University, and Weill Cornell Medicine.
According to the study, early and quicker diagnoses of the disease at a localized stage have mainly been responsible for the sluggish but steady increase in breast cancer incidence since 2004 of roughly 0.5% per year.
Researchers found that, in contrast, the death rates from breast cancer have been progressively declining since its high in 1989, with a decline of 1.9% from 2002 to 2011 and 1.3% from 2011 to 2022 after.
Dr. Samuel Cykert, a professor of medicine at the University of North Carolina School of Medicine in Chapel Hill and an expert on racial disparities in cancer care, was unsurprised by the persistent racial disparities outlined in the latest American Cancer Society report.
“The fact that the gap is still there doesn’t surprise me because people haven’t focused on it to do something about it,” said Cykert.
“In the late ’70s, outcomes were equal. The reason for that is at that time, the diagnosis was lousy, and treatment was very crude, and so nobody had excellent care, and so deaths were equal in both groups,” he said. “Then, as you look at the graphs between 1976 and 1985, they split off where the mortality for White patients markedly improved, and for Black patients, they improved, but not so much, and then around the mid-80s, the gap has remained constant until today.”
According to Cykert, it is crucial to give Black women the same access to hospitals, breast cancer screenings, and effective treatments as White women to eradicate racial disparities among cancer patients.
“You really need two things. You need a system change that acknowledges that there are disparities and care and outcomes,” Cykert said.
“You also need community involvement so that individual health systems understand what the barriers are for their community. Plus, there also needs to be accountability,” he said, adding that “healthcare systems should use their digital data to look at treatment progress for all their patients in real-time, especially disadvantaged groups, and build systems to keep engaging folks to complete all care.”
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