The gap in breast cancer mortality rates among black and white women has narrowed over three decades


Mammograms showing a normal breast (left) and a breast with cancer (right). Credit: public domain

According to the results of a study published in women diagnosed with breast cancer in Florida, breast cancer mortality rates have declined more among black and Hispanic women than white women. Cancer epidemiology, biomarkers and prevention, a journal of the American Association for Cancer Research.

“Over the past three decades, we have seen an improvement in survival for all women, especially for minority women, which is encouraging, “said study lead author Robert Hines, Ph.D., MPH, associate professor of health sciences at the population in the University of Florida In the most recent period of time, non-Hispanic black women have twice as many deaths from breast cancer as non-Hispanic women. . “

Around 1990, breast cancer mortality rates began to decline, reflecting improved screening and the availability of new therapeutic products, but the decline was much slower in black women, Hines said.

“Since the 1980s, there has been a growing awareness about disparities in breast cancer mortality and the worrying fact that they have grown over time,” Hines said. “There has been a big investment in reducing or eliminating these disparities, but we wanted to see if it has been effective.” These initiatives have largely focused on improving education and screening availability for socioeconomically disadvantaged populations and racial and ethnic minorities.

Hines and colleagues obtained records from the Florida Cancer Data System of more than 250,000 women diagnosed with breast cancer between 1990-2015. Its set of samples consisted of who self-identified as non-Hispanic whites (79.5%), non-Hispanic blacks (10.5%), Hispanic whites (9.7%), or Hispanic blacks (0.3%). The researchers studied the cumulative incidence of death from breast cancer, as well as the relative risk rates of 5 and 10 years for individuals in each group. They grouped patients according to the year of diagnosis: 1990-1994, 1995-2004, and 2005-2015.

Nationally, in recent decades, the incidence of breast cancer diagnosis in black women has been lower than in white women, and black women are more likely to be diagnosed with more advanced disease. Over time, the incidence of black women increased to almost the same level as that of white women, an effect that Hines attributes to targeted breast cancer surveillance in these populations.

“The percentage of non-Hispanic black women aged 50 to 74 who have had mammograms in the last two years is higher than that of non-Hispanic white women in the latest Florida data,” Hines said. “Clearly the message has come out.”

The researchers also found that, for all racial and ethnic groups, mortality gradually decreased from 1990 to 2015. In non-Hispanic white women, ten-year mortality decreased by 20.6% in the first five years. (1990-1994) at 14.0% in the final time period (2010-2015). In non-Hispanic black women, ten-year mortality decreased from 36.0% to 25.9%.

In the last ten years surveyed, there were no significant differences in five- or ten-year mortality rates between Hispanic white women and non-Hispanic white women, data that Hines found surprising and encouraging. But despite these advances, Hines points out that black women still have twice the five- and ten-year mortality rates of non-Hispanic white women.

“We need to celebrate the progress we are making,” Hines said. “But we have a way to produce fair results for women diagnosed with breast cancer.”

As next steps, Hines and his team hope to identify specific factors underlying continued disparities, in order to advise on future initiatives aimed at bridging the gap. The results of the current study hinted at possible directions. When the researchers normalized mortality data based on age, state of insurance, poverty of census tracts, stage and degree of tumor on diagnosis and treatment received, the relative rate of 10 years for black women, which was 102 percent higher than white women before data normalization, it decreased to 20 percent more than white women. .

“These factors, as a group, explained a lot of disparities, but to have the biggest impact, we have to bring about the most responsible individual factors,” Hines said.

The limitations of this study include incomplete data for a fraction of patients, especially at earlier times, when some of the diagnostic criteria often used today were not routinely evaluated. The study also excluded patients who identified themselves as a different race to black or white or a different ethnicity from Hispanic.

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More information:
Cancer epidemiology, biomarkers and prevention (2021). DOI: 10.1158 / 1055-9965.EPI-20-1746

Citation: The gap in breast cancer mortality rates among black and white women has narrowed over three decades (2021, July 1) recovered on July 1, 2021 at / 2021-07-gap-breast-cancer-mortality- black.html

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