By Chris Hoenig
A team of University of Pennsylvania researchers believes it can explain why breast cancer is deadlier for Black women than white women—and the study puts the blame on care, not the cancer itself.
Specifically, Black women are being diagnosed when the cancer is at a more advanced and less curable stage, and they then receive lower-quality care after being diagnosed. The team says this is a result of subpar campaigns that have failed to increase early screening and detection in Black communities. “Something is going wrong,” lead author Dr. Jeffrey H. Silber said. “These are huge differences. We are getting there too late. That’s why we are seeing these differences in survival.”
Right now, the life expectancy for Black breast-cancer patients is three years shorter than for whites. Nearly 70 percent of the white women studied survived a minimum of five years after their diagnosis, compared with only 56 percent of Blacks. But Dr. Silber says the gap could shrink dramatically if the cancers were diagnosed earlier. “The remarkable thing we found is that three-year disparity went down to about one year,” he said. Simply increasing the quality of care to the same level received by white women would close the gap by several months, the study said.
The fact that breast cancer is deadlier for Black women has been known for decades, but doctors and scientists have failed to determine if breast cancer is more aggressive in Black women, if Black women’s bodies react differently to the cancer than whites women’s bodies, or if some other biological factor is at play. To maximize their research, the team brought in data from nearly 100,000 white women who have been treated for breast cancer, allowing them to select patients that provided the best possible match for the type and aggressiveness of cancer to compare to their 7,375 Black subjects.
The data the researchers broke down paint a pretty clear picture. Twenty percent of the Black women studied were diagnosed when the cancer was at a far more deadly Stage III or IV, nearly double the percentage of white women. The team also found that among patients with similar tumors, nearly 6 percent of Black women had not started treatment after three months, compared with just 2.5 percent of whites. Perhaps most troubling, 12.6 percent of Black patients showed no evidence of treatment at all, a statistic shared by less than 6 percent of the white women in the study.
Eliminating Health Disparities
Eliminating health disparities and improving patient outcomes is the focus of DiversityInc’s health summit, Culturally Competent Healthcare: How Diversity Creates Better Patient Outcomes, on Sept. 24 in Newark, N.J. In addition to presentations on eliminating these gaps in healthcare and medicine, the event includes speakers and panels on understanding patient values, increasing diversity in clinical trials to improve research outcomes, and using multicultural marketing to help reduce health disparities.
Thomas Zenty III, CEO of University Hospitals, No. 1 in the DiversityInc Top 10 Hospital Systems, recently discussed the impact of diversity management and new healthcare reform laws with DiversityInc CEO Luke Visconti, noting the growing need for hospitals and other providers to take a proactive approach to eliminating racial gaps in healthcare coverage.
“Many studies have shown that there is a direct correlation between people of diverse backgrounds being willing to seek care and knowing that people who look like them will actually be providing that care. So the intersection between diversity and disparities is rather significant,” Zenty explained. “We want to make certain that we’re doing everything that we can to make sure that people of color will be able to work in our organization, hold positions of leadership—caregivers, clinicians and support staff.”