RACIAL DISPARITIES & BREAST CANCER

Leah CalvertPHE 510: Public Health & Social JusticeSpring 2009

INTRO 10% drop in breast cancer rates in U.S.

Racial disparity in health outcomes

Higher death rates, but lower incidence

Public health professionals have a responsibility to address and reduce health disparities

BREAST CANCER FACTS All women at risk – tends to increase with

age

Most commonly diagnosed cancer in African American women

2nd to only lung cancer in female deaths

Most common type (excluding non-melanoma skin cancer)

RACIAL DISCRIMINATION & BREAST CANCER Association between racial discrimination &

stress

Study: racial discrimination & risk of developing breast cancer

On the job discrimination – 32% higher risk of breast cancer

HEALTH DISPARITIES : INCIDENCE

Incidence Rates by Race (2007 statistics from CDC)

Race/Ethnicity Incidence Per 100,000 women

All Races 127.8

White 132.5

African American 118.3

HEALTH OUTCOMES

5 year survival rate, 60% compared to 77% (1975)

5 year survival rate, 70% compared to 85% (1990)

5 year survival rate, 74% compared to 97% (2001)

HEALTH DISPARITIES: MORTALITY

Mortality Rates by Race/Ethnicity (2007 Statistics from CDC)Race/Ethnicity Mortality Rate per 100,000

All Races 25.5

White 25.0

African American 33.8

DELIVERY OF HEALTH CARE

Percentage of U.S. women (age 40+) who received a mammogram in past year

Screening raises odds 70% in among African American women

Year of Mammogram (Data from CDC)Race 1994 1998 2000 2003 2005White 60.6 67.4 71.4 70.1 67.4African American

64.3 66.0 67.8 70.4 64.9

DELIVERY OF HEALTH CARE Less likely to be caught in early stages

Less adequate screening results/follow-up

“Did not discuss test/examination findings”

34% had survival knowledge – compared to 57% of white counterparts

OPPORTUNITIES TO REDUCE DISPARITIES Educate African American women about

breast cancer outcomes

Work within health systems to improve physician/patient communication

Continue to promote screening – but focus on improving follow-up care for African Americans

WORKS CITED  American Cancer Society. “Race and Ethnicity affect Breast Cancer Outcome.” Feb 2 2003.

http://www.cancer.org/docroot/NWS/content/NWS_1_1x_Race_And_Ethnicity_Affect_Breast_Cancer_Outcome.asp. Accessed 24 April 2009.

Brach, Cindy and Irene Fraserirector. “Can Cultural Competency Reduce Racial and Ethnic Health Disparities? A Review and Conceptual Model.” Medical Care Research Review. 57.4 (2000): 181-217. http://mcr.sagepub.com.proxy.lib.pdx.edu. Accessed 23 April 2009.

Centers for Disease Control and Prevention. “Mammography Percentages by Race and Ethnicity.” Breast Cancer Statistics. http://www.cdc.gov/cancer/breast/statistics/screening.htm. Accessed 22 April 2009.

DeSantis C., et al. "Temporal trends in breast cancer mortality by state and race.” Cancer Causes Control. 19.5 (2008):537-45. Accessed 20 April 2009. http://www.springerlink.com.proxy.lib.pdx.edu/content/c14t08t54317lg18/?p=51303ae946304ef28f606e7b899de4f6&pi=10

Gamble, Vanessa Northington, MD, PhD. “Under the Shadow of Tuskegee: African Americans and Health Care”. American Journal of Public Health. 87.11 (1997): 1773-1778. http://www.ajph.org/cgi/reprint/87/11/1773.pdf Accessed 25 April 2009.

Grouse, Lynette. “Reducing Disparities in Cancer Health Care.” National Cancer Institute. Nov 2005. http://www.cancer.gov/newscenter/benchmarks-vol5-Ussue6/page1. Accessed 24 April 2009.

Imaginis. “Breast Cancer: Statistics on Incidence, Survival, and Screening.” Imaginis: The Women’s Health Resource. Jan 2008. http://www.imaginis.com/breasthealth/statistics2.asp. Accessed 23 April 2009.

WORKS CITED CONT Lee, Christopher. “Studies Look for Reasons Behind Racial Disparities in Health Care.” The Washington

Post. Oct 2006. http://www.washingtonpost.com/wp-dyn/content/article/2006/10/24/AR2006102401184.html. Accessed 23 April 2009.

Medical News Today. “Breast Cancer Treatment Disparities Between Black, White Women in Georgia Exist Despite Health Insurance Status, Study Finds.” June 2008. http://www.medicalnewstoday.com/articles/109683.php. Accessed 25 April 2009.

Newman, Lisa A. MD et al. “Local Recurrence and Survival Among Black Women With Early-Stage Breast Cancer Treated With Breast-Conservation Therapy or Mastectomy.” Annals of Surgical Oncology. 6.3 (1999):241-248. Accessed 15 May 2009.

Norton, Amy. “Breast Cancer Still Diagnosed Later in Black Women.” Dec 2006. http://www.breastcancer.org/symptoms/new_research/20061204b.jsp) Accessed 20 April 2009.

Reuters Health. “Racial Discrimination Tied to Breast Cancer Risk.” American Journal of Epidemiology. July 2007. http://www.reuters.com/article/healthNews/idUSCOL55188620070705. Accessed 25 April 2009.

Science Daily. “American Cancer Society Report Finds Breast Cancer Death Rate Continues to Drop.” 2007. Accessed 18 April 2009. http://www.sciencedaily.com/releases/2007/09/070925130014.htm

Stanford University, news release: “Ethnic Differences Can Play a Big Role in Medical Treatment,” October 1991. (http://news.stanford.edu/pr/91/911004Arc1132.html) Accessed 22 April 2009.

Surveillance Epidemiology and End Results. “Cancer Statistics: Fast Stats, Statistics Stratified by Race/Ethnicity.” n.d. National Cancer Institute.

Taylor, Teletia R et. al. “Racial Discrimination and Breast Cancer Incidence in US Black Women.” American Journal of Epidemiology. 166.1 (2007):46-54. hhtp://aje.oxfordjournals.org/cgi/reprint/166/1/46. Accessed 22 April 2009.