Despite interventions to bridge the gap in cancer disparities between African American and white women, racial disparities in breast cancer mortality exist. The National Cancer Institute reported that African American women have a higher mortality rate from breast cancer as compared to Caucasian women (33.8 versus 25.0, respectively).
Katie Reeder-Hayes, MD, from the University of North Carolina, Chapel Hill, discussed reasons for breast cancer disparities in African American women, as well as potential solutions to reduce them, during the San Antonio Breast Cancer Symposium on Tuesday, December 5.
The reasons for racial disparities are complex and multifold, including biologic and ecologic factors.
- Differences in presenting stage and uptake of breast cancer screening in African American women as compared to Caucasian women
- Differences in subtype distribution, beginning with overrepresentation of HR-negative, HER2-negative (triple negative) tumors in young African American women and extending to recent evidence of potential biologic differences in HR-positive subtypes
- Barriers to delivery of care for African American women, including chemotherapy and radiation
- The impact of comorbidities such as obesity, health-related quality of life, and financial toxicity on post-diagnosis risk
Reeder-Hayes recommended the following actions to see a meaningful improvement in the survival gap between African American and Caucasian women with breast cancer.
- Examination of how biology and healthcare access lead to poor outcomes and how they can both be targeted to improve outcomes
- Improved access to breast cancer screening
- Improved access to patient-navigation programs, which are known to reduce time between diagnosis and screening and improve patient compliance
- Examination of the impact insurance access has on vulnerable populations, including African American women
- Increased basic and translational research to identify therapeutic targets subtypes that are overrepresented in African American women with breast cancer, including triple-negative and HR-positive cancers