New research out of the University of Pennsylvania confirms what many clinicians have long known: African American women tend to have poorer survival rates from breast cancer. But the reasons, researchers found, go beyond certain notions that care might be inferior or that the cancer is harder to treat.
The study, recently published in the Journal of the American Medical Association, used a Medicare database of over 100,000 breast cancer cases to compare 7,375 older black women with three sets of 7,375 older white women. All had been diagnosed with breast cancer between 1991 and 2005. All got follow up care. Overall, however, survival rates did not change during that time period, with white women more likely to live longer.
The research, done in part by Dr. Kevin Fox and Jeffrey Silber, found that treatment and type of cancer aside, black women were generally diagnosed at later stages in their cancer and were sicker because of other health conditions, like diabetes or high blood pressure. That, in turn, may have "blunted" some of the effectiveness of cancer treatments.
While the authors questioned whether better screening for beast cancer would reduce the disparity, in terms of when treatment is sought and during which stage of cancer, the data did "provide evidence suggesting that black patients diagnosed with breast cancer had previously received less adequate primary care than did white patients in the demographics match."
Needing to "do better"
Several area leaders in the fight against cancer see the report as a call for action.
Evelyn Robles-Rodriguez, an oncology nurse practitioner at Cooper Cancer Institute in Camden and leader of its outreach programs, wasn't involved in the study but says it highlights the need to do a better job at reaching women of color for breast cancer screenings and follow-up.
"Maybe they don't have higher risk for the disease, but they have higher risk of dying from the disease," said Robles-Rodriguez. "We really need to target our outreach."
Local leaders of the Susan G. Komen for the Cure and Living Beyond Breast Cancer agreed.
"It's one more thing that underscores and validates some really important issues that need attention." Said Elyse Spatz Caplan, program director at Living Beyond Breast Cancer. "We need to figure this out and we need to do better."
Robles-Rodriguez said the study itself could be used as an educational tool to demonstrate the importance of screenings and follow-up care, but the findings still "point to fact that our minority communities need different types of outreach to bring them in for screenings."
Robles-Rodriguez said that could involve creating programs that more directly engage with women in casual or social settings.