Our State of Mind By Robin Martin – The American Cancer Society reported in 2019 a decline in breast cancer mortality. As reported in the Breast Cancer Facts and Figures 2019 report, declines are attributed to progress in treatments and early detection. Even in 2019 African-American women, sadly, remain the group with highest adverse outcomes. Disparity in healthcare access, early detection and treatment remain causes of high mortality rates.
Breast Cancer Facts and Figures 2019
The decline in breast cancer mortality has been attributed to both improvements in treatment and earlier detection. However, not all women have benefited equally from these advances, as indicated by the striking divergence in mortality trends between black and white women beginning in the early 1980s.
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This disparity likely reflects a combination of factors that are difficult to parse, including later stage at diagnosis and other unfavorable tumor characteristics, higher prevalence of obesity and other health conditions, less access to high-quality prevention, early detection, and treatment.
For example, black women are more likely to be screened at lower resourced and nonaccredited facilities and also experience longer intervals between mammograms, and between abnormal results and follow-up. Although self-reported screening rates based on national surveys are similar between black and white women, studies indicate that black (and Hispanic) women are more likely than white women to overestimate their screening history.
The black-white disparity has grown as treatment for breast cancers has improved (particularly for HR+ breast cancers), but appears to have peaked in 2011, when rates in NH black.
Incidence rates are highest among non-Hispanic whites (130.8 per 100,000), followed closely by non-Hispanic blacks (126.7). However, NH black women have the highest breast cancer death rate (28.4 deaths per 100,000), more than double that in Asian/Pacific Islander (API) women (11.5), who have the lowest incidence and death rates.
Black women have higher incidence rates than whites before age 40 and are more likely to die from breast cancer at every age.
African American History