Incidence and mortality rates for breast cancer among certain racial minorities
There have been a number or recent studies which examine the breast cancer incidence rate among various ethnic and racial groups. Although there remains speculation that certain racial groups are genetically more or less predisposed to breast cancer development, most experts point to socio-economic factors as the main difference in breast cancer incidence and mortality rates.
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A comparison is given below for the relative incidence and subsequent mortality rates of breast cancer among various racial sub-groups in the USA. These include white, black, american Indian and Alaskan natives, Asians and pacific islanders, and Hispanics. There do appear to be differences in breast cancer incidence rates among different racial groups. Whether this is a question of genetics, diet and lifestyle, and socioeconomic status is unclear. It is also of interest that there does appear to be a significant difference in mortality rates versus incidence rates for breast cancer across different racial and ethnic groups, and this would generally be attributable to health-care related issues.
Breast Cancer incidence rates by race and age group, USA. 1998-2002
Caucasian women have by far the highest incidence of breast cancer, virtually twice as high as Asians and Hispanics. By contrast, Native American women have a low incidence rate for breast cancer. African American women appear to be 80% as prone to breast cancer as Caucasian women. It is also interesting to note that Asian and Hispanic women do not tend to see an increased rate of breast cancer once they reach their mid 50’s. Native American women, in fact, appear to exhibit decreased tendency for breast cancer development during their 60’s.
Mortality rates from breast cancer by race and age group, in the USA, 1998-2002
It would appear that African American women have the highest morality rate for breast cancer, particularly for those aged 45-59. However, Caucasians have a mortality rate nearly as high, and both groups appear to be considerably more prone to death from breast cancer than native Americans, Hispanics, and Asians. In fact, the breast cancer mortality rate for black and Caucasian women is basically twice that of the other racial groups. What is most striking about these statistics is that the mortality rate for black women is slightly higher than that for Caucasian women, even though the incidence rate is considerably lower. This may possibly be do to socio-economic factors such as health care quality and affordability.
In addition, there it is possible that some ethnic-racial groups, native Americans in particular, may not seek traditional western medicine as readily as other groups, preferring traditional healing practices. It is quite possible that there are just as many deaths due to breast cancer, but they have not been diagnosed or attributed to breast cancer. By the time the cancer eventually metastasizes and begins to cause other organs and systems to fail, the cause of death might easily be reported as as being the result of some of these secondary illnesses.
The chart below demonstrates the difference between the rate of invasive breast cancer and the mortality rate across various ethnic groups. Clearly, the number of deaths due to breast cancer development, when compared to the invasive breast cancer incidence rate, is abnormally high for African American and Native American/Alaskan native women.
According to some estimates, the disparity between white women and African American women in terms of breast cancer mortality could be reduced by up to 70% if high quality treatment facilities were available to all women. The average annual female breast cancer death rate in the U.S. is highest for African Americans, at about 36 per 100000 women. It is also interesting to note that the breast cancer mortality rate is higher for Hispanic and American Indian/Alaskan natives than with Asian Americans and Pacific Islanders, in spite of a lower incidence rate among African Americans and American Indians/Alaskan natives.
Five year survival rates for local and node positive breast cancers
During the 1980’s the mortality rates from breast cancer for White Women and African American women was about the same, but since 2000, African American women have an approximately 32% higher death rate from breast cancer. The main reasons for this difference are suggested to be a more advanced breast tumor at time of diagnosis due to non-participation in screening mammography, and, unequal access to prompt, high quality treatment.
During the 1990’s, the five year survival rate after breast cancer diagnosis actually increased from 91% to over 97% for white women in the U.S. for ‘localized‘ breast cancer. However, during the same period, the five year survival rate for local breast cancer increased from 85% to about 90% for African American women. Rates of five year survival for regionally advanced breast cancer (metastasized to the lymph nodes) increased from about 69% to over 80% for White women, and from 55% to 66% for African American women.
It is estimated that breast cancer screening and early detection programs aimed at helping low-income women in the U.S. actually only reach about 12% to 15% of uninsured women between the ages of 50 and 64. Lower income women thus tend to have a more advanced breast tumor at the time of diagnosis, and there are frequently greater delays between first screening and definitive diagnosis.
For further reading, I suggest you visit this page with information on breast cancer survival based on stage, and visit this page for the survival statistics for the most and least aggressive breast cancers.
- Surveillance, Epidemiology, and End Results (SEER) Program, National Cancer Institute, DCCPS, April 2005.
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