New data on breast cancer demonstrate ongoing racial discrepancies in mortality rates between Black women and white women. Regrettably, this serves as just one example of the consequences of unequal healthcare in America. (Learn more: Why the U.S. Urgently Requires More Black Female Doctors)
While breast cancer represents the most prevalent form of cancer among women in the U.S., the mortality rates associated with breast cancer have declined since their peak in 1989, according to a recent study by the American Cancer Society (ACS) published on October 3, 2022. Overall, the rate of death from breast cancer has reduced by 43 percent between 1989 and 2020. Experts attribute this decline to early detection through breast cancer screening, increased awareness of the disease, and improved treatment options.
However, despite the fact that Black women experience a four percent lower occurrence rate of breast cancer compared to white women, Black women face a 40 percent higher mortality rate, as reported by the ACS. Even though American Indian/Alaska Native women have a lower incidence rate, they also have a higher death rate than white women. Additionally, breast cancer currently constitutes the primary cause of cancer-related death in Black and Hispanic women. Furthermore, the death rate among Black women under 50 is double that of white women in the same age group. (Note: breast cancer predominantly affects women aged 50 and above.)
Unfortunately, these figures do not come as a surprise. “We have consistently reported this disparity year after year for a decade,” stated Rebecca Siegel, M.P.H., senior scientific director of ACS Cancer Surveillance and co-author of the study, in a recent publication.
“The recent ACS report merely confirms that this [racial discrepancy in breast cancer mortality rate] has not changed,” commented Eric Winer, M.D., director of Yale Cancer Center and physician-in-chief of the Smillow Cancer Network, to Shape. He adds, “Moreover, it highlights the extent of this disparity, particularly among young Black women.”
The overall reduction in mortality rate among women diagnosed with breast cancer over the past three decades is “promising,” according to Dr. Winer. “However, the significant and unacceptable disparity that exists for Black women, particularly among the younger age group, is truly thought-provoking and frankly, distressing.”
Why Black Women Face Higher Mortality Rates from Breast Cancer
Why does this problem persist?
“I believe that much of the issue stems from the delivery and accessibility of care,” he asserts. “For Black women, unfortunately, the quality of care they receive is likely not on par with what white women receive.”
According to Dr. Winer, there are various factors contributing to this unequal access to care. “It is due to socioeconomic disparities because we understand that factors such as education, income, and health insurance coverage play a role in determining the quality of care,” he explains.
“Some of this can also be attributed to the impact of systemic racism,” Dr. Winer remarks. “Research has shown that racism has a profound effect on an individual’s health. Even if we were to address all of the social issues, there may still be disparities.” For instance, statistics show that Black women are more prone to diabetes, heart disease, and obesity, and they exhibit lower rates of breastfeeding after childbirth. These factors are all associated with an increased risk of breast cancer, as reported by the Breast Cancer Research Foundation.
Additionally, it is worth noting that although young Black women are more likely to develop an aggressive form of cancer known as triple-negative breast cancer compared to their white counterparts, experts argue that this does not solely explain the racial disparity in mortality rates highlighted in the recent ACS article. Dr. Winer points out that the new report demonstrates a discrepancy in outcomes for patients with estrogen receptor positive breast cancer. “The differences in mortality rates cannot be solely attributed to Black women having more aggressive cancers,” Siegel adds in the ACS article.
“As treatments for breast cancer continue to improve, it becomes increasingly unacceptable that significant disparities still exist,” Dr. Winer emphasizes. “When there are curative therapies available, it is tragic if someone is unable to access them.”
How to Bridge the Racial Gap in Breast Cancer Care
The healthcare industry as a whole is striving to diminish the racial divide in breast cancer care. For instance, there are new regulations mandating comprehensive cancer centers in the United States to focus on addressing these disparities in order to qualify for grants, Dr. Winer explains. “Nationally, we are making progress,” he asserts. Furthermore, it is not only crucial for physicians to be aware of these statistics, but they also need to ensure that Black women with breast cancer receive equitable treatment, regardless of their race.
While the healthcare community acknowledges the racial disparities in access to care and quality of care for women with breast cancer, there is still much work to be done. “It is time for healthcare systems to critically examine how they differentially care for Black women,” Siegel states. And that is precisely what Dr. Winer and his colleagues are striving to accomplish.
“As the director of the cancer center here at Yale, we are highly dedicated to addressing this matter,” he affirms.
We are dedicating a significant amount of resources to reduce the disparities in cancer care that exist in our region.
With these statistics in mind, Dr. Winer’s recommendation for Black women is to adhere to screening guidelines (the minimum age for breast cancer screening is 45), seek optimal care if diagnosed with breast cancer, and adhere to the prescribed treatment plan if diagnosed. Certainly, this is easier said than done, acknowledges Dr. Winer. “It is clearly very challenging for many individuals,” he states, acknowledging socioeconomic issues mentioned earlier and structural racism that contribute to barriers for Black women in obtaining a diagnosis and receiving the best possible care.