Black Women Are Still More Likely to Die of Breast Cancer Than White Women — Here's What Experts Want You to Know

The American Cancer Society released new statistics about racial disparities in breast cancer mortality rate.

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New statistics on breast cancer show persisting racial disparities in mortality rates between Black women and white women. Sadly, it's just one example of the consequences of unequal health care in America. (Read more: Why the U.S. Desperately Needs More Black Female Doctors)

While breast cancer is the most common type of cancer among women in the U.S., breast cancer mortality rates have declined since their peak in 1989, according to a new report from the American Cancer Society (ACS) published on October 3, 2022. Overall, the breast cancer death rate dropped 43 percent between 1989 and 2020, which experts attribute to earlier detection through breast cancer screening, greater awareness of the disease, and better treatment options.

However, despite the fact that Black women have a four percent lower incidence rate of breast cancer than white women, Black women have a 40 percent higher mortality rate, reports the ACS. American Indian/Alaska Native women also have a higher death rate than white women even though they have a lower incidence rate. And breast cancer is currently the leading cause of cancer death in Black and Hispanic women. What's more, the death rate among Black women under 50 is double the death rate among white women of the same age group. (Note: breast cancer mostly affects women ages 50 and older.)

Unfortunately, these numbers aren't exactly surprising. "We have been reporting this same disparity year after year for a decade," Rebecca Siegel, M.P.H., senior scientific director of ACS Cancer Surveillance and co-author of the study explained in a recent article.

"What's new [in the recent ACS report] is just showing that this [racial disparity in breast cancer mortality rate] hasn't changed," Eric Winer, M.D., director of Yale Cancer Center and physician-in-chief of the Smillow Cancer Network, tells Shape. "And showing the extent to which the disparity exists, particularly for young Black women," he adds.

The overall decrease in mortality rate among women diagnosed with breast cancer over the past 30 years is "encouraging," says Dr. Winer. "But I think that the — I would call dramatic and unacceptable — disparity that exists for Black women and particularly young Black women is really sobering and quite honestly horrifying."

Why Black Women Are More Likely to Die of Breast Cancer

So, why does this issue persist? "I think most of us believe that much of the challenge relates to delivering care and making sure that care is available and effectively delivered to everybody," he says. "And I think that for Black women...the care they receive, unfortunately, is probably not equivalent to what white women receive."

There are a number of factors contributing to this unequal level of and access to care, according to Dr. Winer. "It's due to socioeconomic differences because we know that education and income and having health insurance versus not [having health insurance] play a role in the care that you receive," he says.

"Some of this, of course, may also be attributed to the experience of systemic racism," says Dr. Winer. "It's been shown that racism has a very profound effect on one's health. And so even if we corrected all of the social problems, there might still be a difference." For example, Black women are statistically more likely to have diabetes, heart disease, and obesity, and they are less likely to breastfeed after childbirth. These are all risk factors for breast cancer, reports the Breast Cancer Research Foundation.

It's also important to note that while young Black women are more likely to have an aggressive type of cancer (called triple negative breast cancer) than their white counterparts, this isn't to blame for the racial mortality rate gap spotlighted in the recent ACS article, according to experts. The new report shows a disparity in outcomes for patients with estrogen receptor positive breast cancer, points out Dr. Winer. "The differences in death rates are not explained by Black women having more aggressive cancers," added Siegel in the ACS article.

"The better our treatment gets for breast cancer, the more unacceptable it is that there are these big disparities," adds Dr. Winer. "When you have diseases where there's curative therapy, it's just tragic if somebody can't get it."

How to Close the Racial Gap In Breast Cancer Care

The health-care industry as a whole is working to close the racial gap in breast cancer care. For instance, there are new guidelines requiring comprehensive cancer centers in the U.S. to focus on issues related to these disparities in order to receive grants, according to Dr. Winer. "So, I think nationally we are taking steps forward," he says. Additionally, not only do physicians need to be aware of these statistics, but they need "to make sure that Black women with breast cancer get the same treatment that they would give to a white woman," he says.

While the health-care community at large is aware of racial disparities in access to care and care itself for women with breast cancer, there's clearly more work to be done. "It is time for health systems to take a hard look at how they are caring differently for Black women," said Siegel. And that seems to be exactly what Dr. Winer and his associates are doing.

"This is something, as the cancer center director here [at Yale], that we are very focused on," he says. "We are focusing a tremendous amount of resources on trying to diminish the cancer care disparities that exist in our region."

With these statistics in mind, Dr. Winer's advice for Black women is to follow screening recommendations (the minimum age for breast cancer screening is 45), seek the best possible care if diagnosed with breast cancer, and stick with the prescribed course of treatment given if diagnosed. Of course, this is easier said than done, acknowledges Dr. Winer. "It's clearly very challenging for many people," he says, noting socioeconomic issues cited above and systemic racism that contribute to obstacles for Black women to get diagnosed and receive the best care possible.

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