Remarkable progress has been made in breast cancer screening and care in the past 20 years. Survival is improving, surgery can be less invasive in most cases, targeted therapies with fewer side effects are available, and not every breast cancer has to be treated with harsh chemotherapy.
However, even with all of this progress, one recent study(2012 Racial Disparity in Breast Cancer Mortality Study), funded by the Avon Foundation for Women, suggests these advances aren’t available to everyone. Dr. Steve Whitman of the Sinai Urban Health Institute and I recently reported on the breast cancer mortality rate in black and white women in 24 of the largest U.S. cities. In 21 of the 24 cities, we found that black women had higher mortality rates from breast cancer. Since the size of the disparity varied by city, we know the disparity is primarily due to a woman’s access to screening and treatment services. Some cities, like New York City, have public hospitals offering low-cost or free screenings throughout all five boroughs; other cities, like Chicago, which has a much higher disparity, have fewer public hospitals, making it much more difficult for women to get mammograms.
The 2012 Racial Disparity in Breast Cancer Mortality Study also showed that black women are not dying from breast cancer any more than they were in the past; it’s that white women are dying less. For the last 20 years, the breast cancer mortality rate for black women has remained the same, but the rate for white women has been cut in half because they have access to the new advances in diagnosis and treatment. Although genetic factors cause about 10% of the disparity (black women get more aggressive forms of the disease, such as triple-negative breast cancer), 90% of the disparity is due to societal issues such as poverty, racial inequities and a lack of culturally relevant education about breast cancer. This racial disparity in breast cancer deaths obviously must change, but the fact that some women are dying less because of fixable societal issues is hopeful news for all women.
How can we change these societal issues?
· First, we must ensure that all women are educated about the importance of breast health screening. Although most people are “aware” of breast cancer, awareness alone doesn’t save lives. All women must understand their risks, the importance of screening and how to get low-cost screenings. Women should speak to their doctors and educate themselves about their options.
· Second, all women must have access to screening regardless of their ability to pay. The Centers for Disease Control (CDC) enables women to search for free and low-cost screenings across the country.
· Third, all women who need treatment must receive high-quality treatment in a timely manner and complete their recommended therapy.Far too manywomen miss their treatment because they can’t afford the transportation or childcare. The AvonCaresprogram at CancerCare provides financial assistance for homecare, childcare and transportation.Learn more about the AvonCares program at 1-800-813-HOPE (4673).
We believe this is a fixable problem because many of the contributing factors, such as poverty, are societal. For information on ways to help fund programs to overcome this disparity, visit theAvon Foundation online.
Compounding the disparity is the reality that more cancers develop in black women at younger ages—years when mammography does not work and is not routinely recommended. A recent research breakthrough might help solve this problem. Using ultrasound to detect breast cancer, in addition to mammography, as reported in a recent medical article by Dr. Wendie Berg of the Magee-Womens Hospital at the University of Pittsburgh, could identify cancers missed by a mammogram. However, ultrasound also identified more false positives which caused some women to needlessly have a biopsy performed. Though breast imaging by mammography or ultrasound is not perfect, it is available. And it can help save women’s lives.
Remember: early detection can help save your life. Discuss breast cancer screening with your doctor, a nurse, or a medical provider. Make informed decisions about what age to start mammography. Get to know your risk and risk reduction strategies.If you’re looking for further ways to get involved and raise awareness consider signing up for an Avon Walk for Breast Cancer. There are six walks remaining in 2012, including: Chicago (June 2-3), Rocky Mountains (June 23-24), San Francisco (July 7-8), Santa Barbara (September 22-23), New York (October 20-21), Charlotte (October 27-28). And it’s not too early to sign up for a 2013 Walk. I’m pleased to offer a $10 registration discount for More.com readers. When registering at www.avonwalk.org, just enter the code “WALK2″ at checkout to receive the discount.
For more breast cancer information and resources, visit www.cancer.org or http://www.avonfoundation.org/breast-cancer-crusade/.
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