Does Race Matter in Breast Cancer?

Ethnic Background and Race Make a Difference
This question has been appearing in scientific literature for at least the past decade. The answer is always, "Yes, it does."

The causes of breast cancer are difficult to pin down. What makes breast cancer so much more terrible in women of color?

Are the tumors more aggressive, the genes more prone to cancer, or the cultural or socio-economic factors contributing to a lower survival rate?

Mammogram referrals seem to be black and white
The contrast between African American and Caucasian women is found in every index.

A study by Columbia University School of Public Heath reported that physicians' recommendations for mammography were different according to race.

If a white physician had a predominantly black practice, mammography screening was recommended only 7 percent of the time compared to the physician with a white practice where mammography was suggested 23 percent of the time.

Data from the National Breast and Cervical Cancer Early Detection Program revealed that 48.4 per cent of screening mammograms provided in 1993 were for white women while only 14.7 percent were for black women.

Although fewer black women contract breast cancer, 10 per cent are likely to have breast cancer before 40 compared to 5 per cent of white women. Mammograms are known to be less effective at catching tumors in younger women. The studies suggest that African American women are 12 percent more likely to have an initial diagnosis of a stage III or stage IV tumor.

What causes this?
Poverty, lack of health insurance and transportation as well as cultural factors keep women from seeking treatment. This combination of factors may help to explain why cancer is often diagnosed at later stages in women of color.

When cancer is discovered the survival rate for black women is lower than for white women.

In 2001 the American Cancer Society reported that mortality in blacks was 15 percent higher than in whites. Only part of this difference can be attributed to the later stage at diagnosis.

Some studies have suggested that the rate of obesity in black women may contribute to these statistics. High levels of estrogen and high dietary fat intake are related. This might account for the more aggressive behavior of tumors in the African American woman.

Other studies report that cultural beliefs keep women from demanding adequate treatment. Mistrust of clinical trials are linked to real abuses in the past, but without taking part in research studies women are cut off from an important treatment option.

The power of prayer may be strong, but using medical intervention to fight cancer helps to create miracles.

What can we do to improve this picture?
Breast self exams and mammograms are more important for African American woman than any other group.

If you are used to eating a diet high in fats, it would be sensible to consider making some changes.

Join advocacy groups. Make sure that minority women are equally represented in clinical studies, so more answers and better treatments can be found.

Be a personal advocate.
Let people in your community know the importance of early detection and aggressive treatment.

If you are a health care provider, be aware of the physiological as well as the cultural needs of your patient population. Don't add to the statistics that say more white than black women are referred for mammograms.

The battle against breast cancer has to include all of us in order to be a success.

 

January 17, 2000

Last updated March 30, 2006

Elsewhere on the Web:

Breast Cancer : U.S. Racial/Ethnic Cancer Patterns
Breast Cancer - Race & Ethnicity
NCC Research Studies - Race / Ethnicity