scholarly journals Assessing the Racial and Ethnic Disparities in Breast Cancer Mortality in the United States

2017 ◽  
Vol 14 (5) ◽  
pp. 486 ◽  
Author(s):  
Clement Yedjou ◽  
Paul Tchounwou ◽  
Marinelle Payton ◽  
Lucio Miele ◽  
Duber Fonseca ◽  
...  
Keyword(s):  
Breast Cancer ◽  
United States ◽  
Cancer Mortality ◽  
Breast Cancer Mortality ◽  
Ethnic Disparities ◽  
The United States ◽  
Racial And Ethnic Disparities

Racial and Ethnic Disparities in Breast Cancer Mortality: Are We Doing Enough to Address the Root Causes?

2006 ◽  
Vol 24 (14) ◽  
pp. 2170-2178 ◽  
Author(s):  
Dionne J. Blackman ◽  
Christopher M. Masi
Keyword(s):  
Breast Cancer ◽  
Health System ◽  
Cancer Mortality ◽  
White Women ◽  
Breast Cancer Mortality ◽  
Ethnic Disparities ◽  
The United States ◽  
System Level ◽  
Screening Tests ◽  
Racial And Ethnic Disparities

Breast cancer is the most common noncutaneous malignancy and the second most lethal form of cancer among women in the United States. Mortality from breast cancer has declined since the late 1980s, but this decline has been steeper among white women compared with black women. As a result, the black:white mortality rate ratio has increased over the last two decades. Other ethnic minorities also suffer from disproportionately high breast cancer mortality rates. This review discusses the causes of racial and ethnic disparities in breast cancer mortality and describes the most common approaches to reducing these disparities. The literature suggests that outcome disparities are related to patient-, provider-, and health system–level factors. Lack of insurance, fear of testing, delay in seeking care, and unfavorable tumor characteristics all contribute to disparities at the patient level. At the provider level, insufficient screening, poor follow-up of abnormal screening tests, and nonadherence to guideline-based treatments add to outcome disparities. High copayment requirements, lack of a usual source of care, fragmentation of care, and uneven distribution of screening and treatment resources exacerbate disparities at the health system level. Although pilot programs have increased breast cancer screening among select populations, persistent disparities in mortality suggest that changes are needed at the policy level to address the root causes of these disparities.

Association between breast cancer mortality-to-incidence ratios and state health disparities in the United States.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. 1548-1548
Author(s):  
Yu-Che Lee ◽  
Ko-Yun Chang ◽  
Judith Hurley
Keyword(s):  
Breast Cancer ◽  
United States ◽  
Health Disparities ◽  
Cancer Mortality ◽  
Breast Cancer Mortality ◽  
Health Spending ◽  
State Level ◽  
The United States ◽  
State Health ◽  
Per Capita

1548 Background: Breast cancer is the most commonly diagnosed cancer and second leading cause of cancer deaths among women in the United States. The cancer mortality-to-incidence ratio (MIR) provides a population-based indicator of cancer survival and has been established previously to evaluate healthcare variations among different countries. We aim to evaluate the association, which has not been investigated before, between MIR of breast cancer and state-level health disparities in the United States. Methods: We used United States Cancer Statistics (USCS) database to calculate 6-year average of MIRs for breast cancer from 2010 to 2015. America’s Health Rankings (AHR) is a platform using weighted measures in 5 different categories (Behaviors, Community & Environment, Policy, Clinical Care and Outcomes) to determine annual state health rankings. Six-year average (2010-2015) of health uninsured rate by state was obtained from the U.S. Census Bureau and 5-year average (2010-2014) of health spending per capita by state was obtained from Centers for Medicare & Medicaid Services. The correlations between breast cancer MIRs and state health variables were calculated by linear regression analyses. Results: From 2010 through 2015, 1,390,357 females were diagnosed with breast cancer and 246,671 females died from breast cancer in the United States. The 6-year average of age-adjusted incidence rate, mortality rate and MIRs were 124.2 ± 1.3 per 100,000 population, 21.1 ± 0.6 per 100,000 and 0.170 ± 0.007, respectively. Among fifty states we included for analyses, Hawaii had the lowest MIR (0.116 ± 0.014) and Nevada had the highest MIR (0.204 ± 0.004). AHR showed Hawaii had the highest health ranking (No. 1) whereas Louisiana had the lowest health ranking (No. 50) in 2015. In our analysis, states with better health rankings, lower health uninsured rates and higher health spending per capita were significantly correlated with lower MIRs (R2 = 0.695, 0.453 and 0.253, respectively; all P < 0.001). Conclusions: The difference of MIRs for breast cancer was strongly associated with state health diversities. These findings suggest that MIR of breast cancer can be an applicable measure to evaluate and reflect the state-level health disparities in the United States. [Table: see text]

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