By E.J. Mundell
NEW YORK, Jan 04 (Reuters Health) -- African-American women with breast
cancer are 67% more likely to die from their illness than white patients are,
according to a report. The researchers believe that economic, cultural, and
genetic factors contribute to this race-specific difference in death risk.
The findings highlight "the need for public health measures designed to
increase education and screening among African-American women," according to Dr.
Sue A. Joslyn of the University of Northern Iowa in Cedar Falls, and Dr. Michele
M. West of the University of Iowa in Iowa City.
They examined National Cancer Institute data on the survival of over
135,000 US women diagnosed with breast cancer between 1988-1995.
Reporting in the January issue of the journal Cancer, Joslyn and West
found that after adjusting for age, cancer stage at diagnosis and other factors,
black women had a higher risk for dying from breast cancer compared with whites.
What might account for this race-specific increase in death risk?
According to Joslyn, "African-American women are more than twice as likely to be
diagnosed at a later stage of breast cancer -- after the cancer has already
spread in the body" -- compared with white women. These cancers are "much more
difficult to treat, and (have) a much worse prognosis" than cancers caught
early.
According to the investigators, previous studies have suggested that
"cultural barriers and beliefs" -- such as a heightened fear of x-ray radiation
-- may "prevent African-American women from seeking cancer screening."
Genetic differences between the races may also contribute to the increased
risk of dying from breast cancer among African-American women. Joslyn told
Reuters Health that black patients "are more likely to have a more aggressive
form of tumor" than whites. African-American women with breast cancer also tend
to be diagnosed at a "significantly younger" age compared with white patients.
Overall, 33% of black patients were under 50 years of age at time of diagnosis,
compared with 25% of whites. Breast cancers in younger women are usually more
aggressive than those found in older women.
Other factors, including higher risks for obesity, poverty, and poor
educational status, may also play a role in the raising cancer death risks in
black women, the authors conclude.
Joslyn believes more needs to be done to educate African-American women as
to the necessity of regular mammography screening. Experts now recommend that
all women over 40 years of age undergo mammography screening at least once each
year. However, because breast cancer appears to strike black women at a
relatively younger age, Joslyn now believes that "African-American women may
benefit from earlier mammograms, maybe in their early 30s."
Breast cancer is second only to lung cancer as the leading cause of cancer
death in American women. The American Cancer Society estimates that in 1999,
175,000 women were diagnosed with invasive breast cancer, and over 43,000 women
died of the disease.
