Thursday, October 29, 2015

Breast Cancer Rates for Blacks Catch Up to Whites

Black women have long been more likely to die of breast cancer than white women, but this frightening statistic was once tempered a bit because black women were less likely than whites to get breast cancer in the first place.
No more. A new report from the American Cancer Society finds black women are just as likely to get breast cancer as their white neighbors, and they are 42 percent more likely to die of it.

"From 1989 to 2012, breast cancer death rates have decreased by 36 percent; and, as a result, 249,000 U.S. breast cancer deaths have been averted during this time period," the American Cancer Society's Carol DeSantis and colleagues write in their report.
"Widening racial disparities in breast cancer mortality are likely to continue, at least in the short term, in view of the increasing trends in breast cancer incidence rates in black women," DeSantis's team writes in CA: A Cancer Journal for Clinicians.
"Although the overall breast cancer incidence rate is slightly lower in black women than in white women, the breast cancer death rate is 42 percent higher in blacks than in whites."
A combination of factors is likely to blame. Black women are often diagnosed when their breast cancer is at a later stage; they are more likely to be obese and to have other conditions, such as diabetes; they're more likely to get aggressive and hard-to-treat tumors; they're less likely to have access to good health care; and they're less likely to be offered, and to accept, the best treatment options.
Several studies offer clues — there may be genetic differences, there may be disparities in getting medical care, and black women may simply avoid doctors more. A 2013 study found black women were often sicker to start with, suffering other conditions besides breast cancer.
"Black women are also disproportionately diagnosed with triple-negative breast cancers," DeSantis's group wrote. This type of tumor is very difficult to treat.
According to the National Cancer Institute, 25 in every 100,000 white women die of breast cancer. Nearly 34 in every 100,000 African-American women die of breast cancer. Just 16 out 100,000 Hispanic and American Indian women die of breast cancer.
This week's study finds similar patterns. Hispanic women may have lower breast cancer rates, DeSantis and colleagues said, because they have children at younger ages and have more children than women from other ethnic groups. Having children younger protects from breast cancer, as does breastfeeding those children.
"About 12 percent of women in the U.S. (or 1 in 8) will be diagnosed with breast cancer in their lifetime," the researchers wrote.
"This lifetime risk represents an average of the risks of different women, rather than the risk of any one woman. Lifetime risk includes the possibility that women will die from other causes before being diagnosed with breast cancer and is often misinterpreted to apply only to women who live to very old ages."
What can women do?
"The World Cancer Research Fund International estimates that one third of breast cancers could be prevented through healthy behaviors, including maintaining a healthy body weight, engaging in regular physical activity, and not drinking alcohol," the researchers noted.
"There is growing evidence that high levels of fruit and vegetable consumption may reduce the risk of hormone-receptor-negative breast cancer." That's the kind that cannot be treated with the most common hormone-based drugs, including tamoxifen and Herceptin.

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