Transcript Racial Disparities and Breast Cancer – Calvert – 2009

RACIAL DISPARITIES &
BREAST CANCER
Leah Calvert
PHE 510: Public Health & Social Justice
Spring 2009
INTRO
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10% drop in breast cancer rates in U.S.
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Racial disparity in health outcomes
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Higher death rates, but lower incidence
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Public health professionals have a responsibility
to address and reduce health disparities
BREAST CANCER FACTS
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All women at risk – tends to increase with age
Most commonly diagnosed cancer in African
American women
2nd to only lung cancer in female deaths
Most common type (excluding non-melanoma
skin cancer)
RACIAL DISCRIMINATION & BREAST
CANCER
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Association between racial discrimination &
stress
Study: racial discrimination & risk of developing
breast cancer
On the job discrimination – 32% higher risk of
breast cancer
HEALTH DISPARITIES : INCIDENCE
Incidence Rates by Race (2007 statistics from CDC)
Race/Ethnicity
Incidence Per 100,000 women
All Races
127.8
White
132.5
African American
118.3
HEALTH OUTCOMES
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5 year survival rate, 60% compared to 77% (1975)
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5 year survival rate, 70% compared to 85% (1990)
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5 year survival rate, 74% compared to 97% (2001)
HEALTH DISPARITIES: MORTALITY
Mortality Rates by Race/Ethnicity (2007 Statistics from CDC)
Race/Ethnicity
Mortality Rate per 100,000
All Races
25.5
White
25.0
African American
33.8
DELIVERY OF HEALTH CARE
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Percentage of U.S. women (age 40+) who received
a mammogram in past year
Year of Mammogram (Data from CDC)
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Race
1994
1998
2000
2003
2005
White
60.6
67.4
71.4
70.1
67.4
African
American
64.3
66.0
67.8
70.4
64.9
Screening raises odds 70% in among African
American women
DELIVERY OF HEALTH CARE
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Less likely to be caught in early stages
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Less adequate screening results/follow-up
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“Did not discuss test/examination findings”
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34% had survival knowledge – compared to 57%
of white counterparts
OPPORTUNITIES TO REDUCE DISPARITIES
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Educate African American women about breast
cancer outcomes
Work within health systems to improve
physician/patient communication
Continue to promote screening – but focus on
improving follow-up care for African Americans
WORKS CITED
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American Cancer Society. “Race and Ethnicity affect Breast Cancer Outcome.” Feb 2 2003.
http://www.cancer.org/docroot/NWS/content/NWS_1_1x_Race_And_Ethnicity_Affect_Breast_C
ancer_Outcome.asp. Accessed 24 April 2009.
Brach, Cindy and Irene Fraserirector. “Can Cultural Competency Reduce Racial and Ethnic
Health Disparities? A Review and Conceptual Model.” Medical Care Research Review. 57.4
(2000): 181-217. http://mcr.sagepub.com.proxy.lib.pdx.edu. Accessed 23 April 2009.
Centers for Disease Control and Prevention. “Mammography Percentages by Race and
Ethnicity.” Breast Cancer Statistics. http://www.cdc.gov/cancer/breast/statistics/screening.htm.
Accessed 22 April 2009.
DeSantis C., et al. "Temporal trends in breast cancer mortality by state and race.” Cancer
Causes Control. 19.5 (2008):537-45. Accessed 20 April 2009.
http://www.springerlink.com.proxy.lib.pdx.edu/content/c14t08t54317lg18/?p=51303ae946304ef2
8f606e7b899de4f6&pi=10
Gamble, Vanessa Northington, MD, PhD. “Under the Shadow of Tuskegee: African Americans
and Health Care”. American Journal of Public Health. 87.11 (1997): 1773-1778.
http://www.ajph.org/cgi/reprint/87/11/1773.pdf Accessed 25 April 2009.
Grouse, Lynette. “Reducing Disparities in Cancer Health Care.” National Cancer Institute. Nov
2005. http://www.cancer.gov/newscenter/benchmarks-vol5Ussue6/page1.
Accessed 24 April 2009.
Imaginis. “Breast Cancer: Statistics on Incidence, Survival, and Screening.” Imaginis: The
Women’s Health Resource. Jan 2008. http://www.imaginis.com/breasthealth/statistics2.asp.
Accessed 23 April 2009.
WORKS CITED CONT
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Lee, Christopher. “Studies Look for Reasons Behind Racial Disparities in Health Care.” The Washington
Post. Oct 2006. http://www.washingtonpost.com/wpdyn/content/article/2006/10/24/AR2006102401184.html. Accessed 23 April 2009.
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Medical News Today. “Breast Cancer Treatment Disparities Between Black, White Women in Georgia
Exist Despite Health Insurance Status, Study Finds.” June 2008.
http://www.medicalnewstoday.com/articles/109683.php. Accessed 25 April 2009.
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Newman, Lisa A. MD et al. “Local Recurrence and Survival Among Black Women With EarlyStage Breast Cancer Treated With Breast-Conservation Therapy or Mastectomy.” Annals of
Surgical Oncology. 6.3 (1999):241-248. Accessed 15 May 2009.
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Norton, Amy. “Breast Cancer Still Diagnosed Later in Black Women.” Dec 2006.
http://www.breastcancer.org/symptoms/new_research/20061204b.jsp) Accessed 20 April 2009.
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Reuters Health. “Racial Discrimination Tied to Breast Cancer Risk.” American Journal of Epidemiology.
July 2007. http://www.reuters.com/article/healthNews/idUSCOL55188620070705. Accessed 25 April
2009.
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Science Daily. “American Cancer Society Report Finds Breast Cancer Death Rate Continues to Drop.”
2007. Accessed 18 April 2009. http://www.sciencedaily.com/releases/2007/09/070925130014.htm
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Stanford University, news release: “Ethnic Differences Can Play a Big Role in Medical Treatment,”
October 1991. (http://news.stanford.edu/pr/91/911004Arc1132.html) Accessed 22 April 2009.
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Surveillance Epidemiology and End Results. “Cancer Statistics: Fast Stats, Statistics Stratified by
Race/Ethnicity.” n.d. National Cancer Institute.
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Taylor, Teletia R et. al. “Racial Discrimination and Breast Cancer Incidence in US Black Women.”
American Journal of Epidemiology. 166.1 (2007):46-54.
hhtp://aje.oxfordjournals.org/cgi/reprint/166/1/46. Accessed 22 April 2009.