Why Black Women Still Don’t Get Adequate Care for Breast Cancer

About 281,550 people in the U.S. will be diagnosed with breast cancer this year—and 43,600 will die from it, according to the American Cancer Society1. When we dig deeper into the numbers, it turns out there are racial disparities at play as seen with so many other health conditions, such as diabetes.

White and Black people are diagnosed with breast cancer at roughly the same rate, but Black people are more likely to die from the disease, according to the Centers for Disease Control and Prevention2. Between the years 2014-2018, CDC data shows that 27 out of 100,000 Black women died from breast cancer compared to 19 out of 100,000 white women. (The death rate for other groups of color is lower than Black women or white women.)

Experts say there are a number of factors at play here, and SELF spoke to Oluchi Oke3, M.D., an oncologist at the University of Texas MD Anderson Cancer Center, to learn more about the harrowing racial disparities in breast cancer. As a Black physician, Dr. Oke understands the importance of closing health care gaps for all patients. 

SELF: To start, what are the most common racial disparities we see in breast cancer?

Dr. Oke: The disparities we see are in the onset of diagnosis—meaning at what stage of cancer people are diagnosed—and also in the overall percentage of people of a certain ethnicity that pass away from breast cancer. We see disparities in the type of breast cancer they get. And the average age for a breast cancer diagnosis is younger in Hispanic and Black individuals4.

Black women are also more likely to be diagnosed with what’s called triple negative breast cancer, which can be hard to treat, and has a poor prognosis. It is more aggressive, so it grows faster, and we find it at a later stage. When we find it later, the cancer may have spread to lymph nodes or to another organ too. And so we are seeing more African American women dying from their breast cancer, partly just because they’re getting diagnosed later, and also because they’re being diagnosed with triple negative breast cancer.

Lack of health insurance is a barrier in receiving timely screening to detect breast cancer early on and is a big reason that we see higher breast cancer death rates in Black women. The most well-known study related to this was published in 2017 by researchers at Emory University5 who reviewed information from over half a million people in the national cancer database. They looked at five factors that may impact the difference in outcome between Black versus Caucasian women with stage 1-3 breast cancer, including demographics, characteristics of cancer, comorbidities, health insurance, and type of treatment. The difference in health insurance was the biggest contributor to the difference in death rate for each group. They showed almost three times as many Black women were uninsured compared to white women, and 35% of the excess risk of death from breast cancer in Black women compared with white women was due to a difference in health insurance. The type of tumor also contributed to the increased risk of death, but not as significantly as the lack of insurance contributed.

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