Disparities Seen in Breast Cancer Survival Rates
RENEE MONTAGNE, host:
A study in this week's Journal of the American Medical Association suggests that black women with breast cancer have shorter survival rates because they have higher rates of other diseases like diabetes and hypertension. Researchers believe controlling those other illnesses could improve survival rates for black women with breast cancer. NPR's Rachel Jones reports.
RACHEL JONES reporting:
For decades, researchers have concluded that when a woman seeks treatment for breast cancer and how advanced the disease is at that point are the most critical factors in determining whether she'll survive the disease. Reams of data have indicated that less access to care and poor quality care are the main reasons black women die of breast cancer more often than whites. But researcher Martin Tammemagi says there's a lot more to it.
Professor MARTIN TAMMEMAGI (Researcher): Our study shows that after more than 10 years of follow-up, more breast cancer patients die of other causes than they do of breast cancer itself.
JONES: Tammemagi is an associate professor of epidemiology at Brock University in St. Catharines, Ontario, Canada. He and his colleagues analyzed data on more than 900 black and white women diagnosed with breast cancer at Detroit's Henry Ford Health System between 1985 and 1990. Besides breast cancer, the women developed at least 77 other illnesses that directly affected how long they might survive an initial breast cancer diagnosis. Researchers noticed that two illnesses, diabetes and hypertension, accounted for most of the disparities between black and white women.
Prof. TAMMEMAGI: The African-Americans had roughly three times as much diabetes and three times as much hypertension as the white breast cancer patients had, and both of these were independent important predictors of survival.
JONES: Tammemagi says the new study is important because of its clinical setting. All of the women were enrolled in the Henry Ford Health System, so that meant they all had access to the most effective treatment for breast cancer, which is surgery. But Tammemagi says the shorter survival rates for black women indicate just how much other factors can influence a breast cancer diagnosis.
Prof. TAMMEMAGI: It may be that there's different access to nutritional foods, habits of eating that promote obesity, weight gain, diabetes. So that is an example how it's not the access but it's the lifestyle and the person's individual cultural background.
JONES: In fact, researchers estimated that more than 40 percent of the disparity in breast cancer survival for black women is directly contributed to these other illnesses. Vicki Mays directs the UCLA Center on Research, Education, Training and Strategic Communication on minority health disparities. She welcomes the new research because she says it's more careful about designating the race of study participants.
Ms. VICKI MAYS (UCLA Center on Research, Education, Training and Strategic Communication): This is an investigator that has overcome a problem we quite often see, which is that sometimes we use data based on what we think the race of the person is. In this particular study, all of the race data is based on self reports.
JONES: Which deepens its insight into racial disparities. Mays agrees with the study's focus on the need for more aggressive treatment of attended illnesses for black breast cancer patients.
Ms. MAYS: But in the interim, if what we're worried about is there seems to be this co-relationship with breast cancer, can we also attempt to do some kind of screening or ensuring that we really focus on self exams as well as the screening process to try and catch that particular disease early?
JONES But Mays cautions that more screening isn't the only solution. She says there needs to be more education for both patients and physicians about the dangers of these secondary illnesses. That kind of teamwork between patients and doctors may be the most positive step toward increasing breast cancer survival rates for black women. Rachel Jones, NPR News, Washington.
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