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William J. Gradishar, MD, FACP, FASCO


Trends in Racial Disparity in Breast Cancer Mortality in the United States

By: Anna Fanelli
Posted: Wednesday, August 10, 2022

According to research published in The New England Journal of Medicine, age-adjusted breast-cancer mortality in the United States is about 40% higher among Black women than among non-Hispanic White women. However, before 1980, breast cancer mortality was slightly lower among Black women than among White women, with the death rates diverging sharply after 1980. Of note, mammography screening and adjuvant endocrine therapy were widely implemented in the United States for breast cancer management in the 1980s.

“Black women continue to have a disproportionate high burden of breast cancer mortality largely because of lack of health insurance and other socioeconomic barriers that limit access to high-quality care,” said senior author Ahmedin Jemal, DVM, PhD, Senior Vice President of Surveillance & Health Equity Science, in an American Cancer Society press release. “To break down disparities in cancer outcomes, it is crucial to increase access to care for underserved populations and develop mechanisms to reverse course, from requirements for increased diversity in clinical trials to health system financial incentives for equitable care,” he commented.

Authors of the study calculated breast cancer incidence and death rates based on hormone receptor status. Despite having a 22% lower incidence rate, Black women with hormone receptor–positive breast cancer have a 19% higher mortality rate compared with non-Hispanic White women.

Researchers in the study also found that Black women with hormone receptor–negative breast cancer, when compared with non-Hispanic White women, have a 123% higher mortality rate, despite having a 65% higher incidence rate. “From 2014 through 2018, a total of 56% of the difference in breast-cancer deaths between Black and White women could be attributed to hormone receptor–negative cancer,” stated the investigators.

“We believe supporting research on the prevention and treatment of triple-negative breast cancer should be a national priority, since such research will be essential for mitigating racial disparities in outcomes and reducing global breast-cancer mortality,” Dr. Jemal and colleagues concluded.

Disclosure: The study authors reported no conflicts of interest.

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