Breast cancer is the most common cancer in American women, with nearly 232,000 diagnosed each year, and another 100,000 women are diagnosed with a gynecologic cancer in the U.S. each year. But do these diseases affect all women equally? In recognition of Breast Cancer Awareness Month, we’re taking a closer look at five things minority women should know about breast cancer and gynecologic cancers, including cervical, endometrial, and ovarian cancers.
- African American women are most likely to be diagnosed with breast cancer at a younger age.
Breast cancer usually occurs in women over age 55, but young women can also develop the disease. Although breast cancer is more common in white women overall, African American women are more likely to develop and die from breast cancer before the age of 35. There are some things all women can do to understand their risk, including knowing their family histories and discussing their risk with their doctors. Breast cancer is not preventable in many cases, but maintaining a healthy routine, including regular clinical exams, can help all women lower their risk and find cancers early. There are also medications (such as tamoxifen) that a woman can consider taking if they have a particularly high risk of of developing breast cancer. These medications help reduce the risk of developing the disease.
- Cervical cancer is most common in Hispanic women.
Cervical cancer is diagnosed in nearly 13,000 American women each year, with the disease found most commonly in Hispanic women, followed by African American women. The Pap test has helped lower the death rate for cervical cancer by more than 50 percent in the past 30 years, but unequal access to this test and human papillomavirus (HPV) vaccinations makes Hispanic and African American women more susceptible to the disease.
- African American women are most likely to die from breast cancer.
While breast cancer is most common in white women, African American women are more likely to die from the disease. According to data from the National Cancer Institute, there are 34 breast cancer deaths per 100,000 African American women compared to 25 deaths for every 100,000 white women. The reason behind this disparity is an ongoing focus of research and is likely a result of differences in treatment receipt, but socioeconomic factors, such as access to care and insurance, and the stage and type of breast cancer when it’s diagnosed, also play important roles.
- African American women are most likely to be diagnosed with endometrial cancer.
Endometrial (uterine) cancer is the most common gynecologic cancer in the U.S. and is on the rise generally, which researchers attribute in part to an increase in obesity. While endometrial cancer is more common in white women, it is more deadly in African American women. The more aggressive tumors found in African American women are difficult to treat. These disparities are seen in data from randomized clinical trials and observational studies, suggesting that there may be fundamental differences in the tumors. In addition, limited access to specialists may play a role in the heightened death rates observed.
- Genetic predisposition varies by ethnicity.
The inherited BRCA1 and BRCA2 genes, which increase a woman’s risk of both breast and ovarian cancers, occur more commonly in those of Ashkenazi (Eastern European) Jewish descent, and globally in Norwegian, Dutch, and Icelandic women. Women with a strong family history of breast or ovarian cancer, or who are diagnosed with these cancers at young ages, should discuss the possibility of genetic testing with their care team. In addition, all women diagnosed with ovarian cancer should undergo genetic testing according to national guidelines.
“The reasons for these disparities are complex, but there is a lot of work being done to eliminate them,” says Rachel Freedman, MD, MPH, a breast oncologist in Dana-Farber’s Susan F. Smith Center for Women’s Cancers and a member of the Institute’s Cancer Care Equity Program. “I hope one day soon we will see them disappear but this will require a continued, large, collective effort on a local and national level. We must continue to try to understand why disparities are occurring and how to assure access to high-quality care for all patients.”
Dana-Farber’s Cancer Care Equity Program serves as a bridge between research and outreach efforts to address disparities at Dana-Farber, and provide high-quality treatment to communities with high risk, but limited access to care. The Dana-Farber Mammography Van, the only mobile digital mammography program in Massachusetts, provides breast cancer screening and education to women in communities throughout the state, including those who are low-income, elderly, immigrant, and non-English speaking.