An updated study on 2022 breast cancer statistics from the American Cancer Society reports that while breast cancer death rates in the United States have dropped, Black women are still more likely to die from the disease when compared to White women.
Since 2004, the incidence of breast cancer across the country has been slowly rising by about 0.5% each year, mostly caused by early disease diagnosis when it is still in a localized stage. In contrast, from 1989 to 2020, the death rate of breast cancer has dropped by 43%, resulting in 460,000 fewer breast cancer deaths. The death rate declined overall for women of all ethnic groups except for American Indians/Alaska Natives, in which their death rate remained stable. Despite the death rate decline and a lower incidence rate of breast cancer in Black women when compared to White women, breast cancer deaths in Black women were overall 40% higher, as well as twice as high in women younger than 50. For every molecular subtype and stage of disease of breast cancer besides stage 1, Black women also had the lowest 5-year survival rate of any racial/ethnic group.
How to Close the Gap in Breast Cancer Disparity
Rebecca Siegel, senior author of the report and senior scientific director of surveillance research at the American Cancer Society, acknowledged that “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.”
“The take-home message is that we really need to take a hard look at how we’re treating Black women differently.”
Dr. Samuel Cykert, professor of medicine at the University of North Carolina School of Medicine in Chapel Hill, who has conducted research on racial disparities in cancer treatment, noted that in the late 1970s, breast cancer outcomes were equal between White and Black patients. “At that time, 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.”
Ensuring that Black patients have the same ease of access to hospitals, breast cancer screenings, and treatment as White patients is key to closing the gap. “You really need two things: You need a system change that acknowledges that there are disparities and care and outcomes,” as well as “community involvement so that individual health systems understand what the barriers are for their community,” Cykert said.
The American Cancer Society also notes that progress in mitigating disparities in breast cancer care can be carried out through increased access to high-quality breast cancer screening and treatment through nationwide programs such as Medicaid expansion and partnerships with community stakeholders, advocacy organizations, and health systems. Supplying equal access to breast cancer care evenly across the country is one of the first steps to minimizing the gap between White and Black breast cancer patients.
