April is National Minority Health Month. As it relates to breast cancer, disparities do not describe all health differences. They are the result of health differences that may arise from inequities such as differences among populations such as race/ethnicity, ancestry, geography, cultural factors, age and more. Find out more about breast cancer disparities.
Female breast cancer is the most commonly diagnosed cancer among nearly every racial and ethnic group in the U.S. However, the past 25 years have seen much improvement in treatment and overall breast cancer care, which have greatly increased survival rates over the years. During this time, overall breast cancer rates have decreased, but have remained stable since 2004. Breast cancer deaths have decreased by as much as 34 percent and continue to decline . These trends indicate real progress. Unfortunately, improvement has not occurred equally among all populations. Many populations within the U.S. continue to be disproportionately burdened by high incidence (new cases) and mortality rates of breast cancer.
These differences lead to, and are often referred to as disparities. They affect how different communities are impacted by breast cancer incidence, mortality and survival. Understanding these differences is critical to reducing breast cancer disparities.
Disparities do not describe all health differences. Disparities are the result of health differences that may arise from inequities such as intentional or unintentional discrimination and/or social disadvantage. They may include, but are not limited to, health differences among populations according to race/ethnicity, ancestry, cultural factors, socioeconomic status, age, sexual orientation, geography, disability or other characteristics associated with social inequality or discrimination .
There are many complex factors that contribute to breast cancer disparities. The most apparent factors are linked to medical care and a lack of health care coverage. However, a person’s health is not just a product of good medical care. Studies show it accounts for only a small percent of disparity related breast cancer deaths. Factors affected by social and racial inequalities such as education, income and the quality of neighborhood environments are thought to play a major role in health disparities [3, 4]. Breast cancer disparities can be affected by:
Socioeconomic and cultural factors
- Poverty, poor education and high unemployment have been linked to breast cancer disparities in all areas of care, from screening to diagnosis to treatment.
- Language and cultural barriers; discrimination related to class, race or religion; and mistrust of the medical field may prevent some women from getting screened, seeking out treatment in a timely manner or receiving the standard of care when seen by a doctor [3, 4, 5].
Even when access to health care services is equal, there are differences in the size, stage and grade of breast cancer for many minority women compared to white women.
- African American and Hispanic women are more likely to develop triple negative breast cancer (TNBC), an aggressive subtype of breast cancer associated with shorter survival [6, 7].
- African American women younger than 40 are twice as likely to be diagnosed with breast cancer as Caucasian women of the same age [8, 9]. They also tend to have higher levels of hormones like estrogen, which may contribute to their increased risk of premenopausal breast cancer .