Editing Breast cancer (section)

== Health disparities in breast cancer ==

There are ethnic disparities in the [[mortality rate]]s for breast cancer as well as in breast cancer treatment. Breast cancer is the most prevalent cancer affecting women of every ethnic group in the United States. Breast cancer incidence among Black women aged 45 and older is higher than that of white women in the same age group. White women aged 60–84 have higher incidence rates of breast cancer than Black women. Despite this, Black women at every age are more likely to succumb to breast cancer.<ref name="Health and Racial Disparity in Brea">{{cite book | vauthors = Yedjou CG, Sims JN, Miele L, Noubissi F, Lowe L, Fonseca DD, Alo RA, Payton M, Tchounwou PB | title = Breast Cancer Metastasis and Drug Resistance | chapter = Health and Racial Disparity in Breast Cancer | series = Advances in Experimental Medicine and Biology | volume = 1152 | pages = 31–49 | date = 3 January 2020 | pmid = 31456178 | pmc = 6941147 | doi = 10.1007/978-3-030-20301-6_3 | isbn = 978-3-030-20300-9 }}</ref>
 
Breast cancer treatment has improved greatly over the years, but Black women are still less likely to obtain treatment compared to white women.<ref name="Health and Racial Disparity in Brea"/> Risk factors such as [[socioeconomic status]], late-stage, or breast cancer at diagnosis, genetic differences in tumor subtypes, and differences in healthcare access all contribute to these disparities. Socioeconomic determinants affecting the disparity in breast cancer illness include poverty, [[Cultural differences in breast cancer diagnosis and treatment|culture]], and social injustice. In Hispanic women, the incidence of breast cancer is lower than in non-Hispanic women, but is often diagnosed at a later stage than white women with larger tumors.

Black women are usually diagnosed with breast cancer at a younger age than white women. The median age of diagnosis for Black women is 59, in comparison to 62 in White women. The incidence of breast cancer in Black women has increased by 0.4% per year since 1975 and 1.5% per year among Asian/Pacific Islander women since 1992. Incidence rates were stable for non-Hispanic White, Hispanics, and Native American women. The five-year survival rate is noted to be 81% in Black women and 92% in White women. Chinese and Japanese women have the highest survival rates.<ref name="Health and Racial Disparity in Brea"/>

=== Disparities in breast cancer screenings ===
Low-income, immigrant, disabled, and racial and sexual minority women are less likely to undergo breast cancer screening and thus are more likely to receive late-stage diagnoses.<ref name="Health and Racial Disparity in Brea" /><ref name=":0">{{cite journal |last1=Makurumidze |first1=Getrude |last2=Lu |first2=Connie |last3=Babagbemi |first3=Kemi |title=Addressing Disparities in Breast Cancer Screening: A Review |journal=Applied Radiology |volume=51 |issue=6 |date=2022 |pages=24–28 |doi=10.37549/AR2849 |id={{ProQuest|2771102441}} |url=https://appliedradiology.com/articles/addressing-disparities-in-breast-cancer-screening-a-review |doi-access=free }}</ref> Ensuring equitable health care, including breast cancer screenings, can positively affect these disparities.<ref name="pmid334195262">{{cite journal |vauthors=Baird J, Yogeswaran G, Oni G, Wilson EE |date=January 2021 |title=What can be done to encourage women from Black, Asian and minority ethnic backgrounds to attend breast screening? A qualitative synthesis of barriers and facilitators |url=https://nottingham-repository.worktribe.com/output/5032502 |journal=Public Health |volume=190 |issue= |pages=152–159 |doi=10.1016/j.puhe.2020.10.013 |pmid=33419526 }}</ref>

Efforts to promote awareness about the significance of screenings, such as informational materials, are ineffective in reducing these disparities.<ref name=":1">{{Cite journal |last1=Nayyar |first1=Shiven |last2=Chakole |first2=Swarupa |last3=Taksande |first3=Avinash B. |last4=Prasad |first4=Roshan |last5=Munjewar |first5=Pratiksha K. |last6=Wanjari |first6=Mayur B. |date=June 2023 |title=From Awareness to Action: A Review of Efforts to Reduce Disparities in Breast Cancer Screening |journal=Cureus |volume=15 |issue=6 |pages=e40674 |doi=10.7759/cureus.40674 |doi-access=free |pmid=37485176 |pmc=10359048 }}</ref> Successful methods directly address the barriers that prevent access to screenings, such as language barriers or lack of health insurance.<ref name=":0" /><ref name=":1" />

Through community outreach in under-served communities, patient navigators and advocates can offer women personalized assistance with attending screening and follow-up appointments. However, the long-term benefits are unclear, primarily due to a lack of resources and staff to sustain these community-based solutions.<ref name=":0" /><ref name=":1" /><ref>{{Cite journal |last1=Nelson |first1=Heidi D. |last2=Cantor |first2=Amy |last3=Wagner |first3=Jesse |last4=Jungbauer |first4=Rebecca |last5=Fu |first5=Rongwei |last6=Kondo |first6=Karli |last7=Stillman |first7=Lucy |last8=Quiñones |first8=Ana |date=October 2020 |title=Effectiveness of Patient Navigation to Increase Cancer Screening in Populations Adversely Affected by Health Disparities: a Meta-analysis |journal=Journal of General Internal Medicine |volume=35 |issue=10 |pages=3026–3035 |doi=10.1007/s11606-020-06020-9 |pmc=7573022 |pmid=32700218}}</ref> Legislation that requires mandatory insurance coverage of language assistance and mammograms has also increased screening rates, particularly among ethnic minority communities.<ref name=":1" /> Innovative solutions proven effective include mobile screening vehicles, telehealth consultations, and online tools to assess potential risks and signs of breast cancer.<ref name=":1" />

=== Disparities in breast cancer research ===
A diverse pool of participants in breast cancer research facilitates the investigation of the disease's unique risks and development patterns in ethnic minority populations.<ref name=":52">{{Cite journal |last1=Sharma |first1=Richa |last2=Tiwari |first2=Amit K. |date=August 2023 |title=Bridging racial and ethnic disparities in cancer research |journal=Cancer Reports |language=en |volume=6 |issue=S1 |pages=e1871 |doi=10.1002/cnr2.1871 |pmid=37528671 |pmc=10440838 }}</ref><ref name=":22">{{Cite journal |last1=Hirko |first1=Kelly A. |last2=Rocque |first2=Gabrielle |last3=Reasor |first3=Erica |last4=Taye |first4=Ammanuel |last5=Daly |first5=Alex |last6=Cutress |first6=Ramsey I. |last7=Copson |first7=Ellen R. |last8=Lee |first8=Dae-Won |last9=Lee |first9=Kyung-Hun |last10=Im |first10=Seock-Ah |last11=Park |first11=Yeon Hee |date=2022-02-11 |title=The impact of race and ethnicity in breast cancer—disparities and implications for precision oncology |journal=BMC Medicine |volume=20 |issue=1 |pages=72 |doi=10.1186/s12916-022-02260-0 |doi-access=free |pmc=8841090 |pmid=35151316}}</ref><ref name=":3">{{cite journal |last1=Bea |first1=Vivian Jolley |last2=Taiwo |first2=Evelyn |last3=Balogun |first3=Onyinye D. |last4=Newman |first4=Lisa A. |title=Clinical Trials and Breast Cancer Disparities |journal=Current Breast Cancer Reports |date=September 2021 |volume=13 |issue=3 |pages=186–196 |doi=10.1007/s12609-021-00422-2 }}</ref> These populations experience better health outcomes from medical treatments designed based on research with diverse patient representation.<ref name=":52" /><ref name=":22" /><ref name=":3" />

Within the United States, less than 3% of patients in clinical trials identify as Black, despite representing 12.7% of the national population.<ref name=":22" /> Hispanic and indigenous women are also significantly underrepresented in breast cancer research.<ref>{{cite journal |last1=Aldrighetti |first1=Christopher M. |last2=Niemierko |first2=Andrzej |last3=Van Allen |first3=Eliezer |last4=Willers |first4=Henning |last5=Kamran |first5=Sophia C. |title=Racial and Ethnic Disparities Among Participants in Precision Oncology Clinical Studies |journal=JAMA Network Open |date=8 November 2021 |volume=4 |issue=11 |pages=e2133205 |doi=10.1001/jamanetworkopen.2021.33205 |pmid=34748007 |pmc=8576580 }}</ref> Lengthy involvement in clinical trials without financial compensation discourages the participation of low-income women unable to miss work or afford traveling expenses.<ref name=":3" /> Monetary compensation, language interpreters, and patient navigators can increase the diversity of participants in research and clinical trials.<ref name=":3" />