scholarly journals Place Is Power: Investing in Communities as a Systemic Leverage Point to Reduce Breast Cancer Disparities by Race

2022 ◽  
Vol 19 (2) ◽  
pp. 632
Author(s):  
Matthew Jay Lyons ◽  
Senaida Fernandez Poole ◽  
Ross C. Brownson ◽  
Rodney Lyn
Keyword(s):  
Breast Cancer ◽  
Racial Disparities ◽  
Systems Theory ◽  
Breast Cancer Incidence ◽  
Racial Equity ◽  
Systemic Racism ◽  
Leverage Point ◽  
Community Stakeholders ◽  
Fundamental Cause ◽  
Breast Cancer Disparities

Racial disparities in breast cancer present a vexing and complex challenge for public health. A diverse array of factors contributes to disparities in breast cancer incidence and outcomes, and, thus far, efforts to improve racial equity have yielded mixed results. Systems theory offers a model that is well-suited to addressing complex issues. In particular, the concept of a systemic leverage point offers a clue that may assist researchers, policymakers, and interventionists in formulating innovative and comprehensive approaches to eliminating racial disparities in breast cancer. Naming systemic racism as a fundamental cause of disparities, we use systems theory to identify residential segregation as a key leverage point and a driver of racial inequities across the social, economic, and environmental determinants of health. We call on researchers, policymakers, and interventionists to use a systems-informed, community-based participatory approach, aimed at harnessing the power of place, to engage directly with community stakeholders in coordinating efforts to prevent breast cancer, and work toward eliminating disparities in communities of color.

scholarly journals Racial Disparities in the Incidence, Breast Conserving Rate and Survival of Breast Cancer Patients Who Underwent Breast Conserving Surgery

2021 ◽  
Author(s):  
Shu Han ◽  
Jianjun Liu ◽  
Weifang Tang ◽  
Shengying Wang ◽  
Shikai Hong
Keyword(s):  
Breast Cancer ◽  
Racial Disparities ◽  
Cancer Incidence ◽  
White Women ◽  
Breast Cancer Incidence ◽  
Relative Survival ◽  
Breast Conserving Surgery ◽  
Incidence Rates ◽  
Breast Cancer Patients ◽  
Cancer Specific Survival

Abstract Objective: In the current study, we aimed to provide a clear insight on the racial disparity of breast conserving rate (BCR) and survival in breast cancer after breast conserving surgery (BCS). Materials and Methods: Using data from the Surveillance, Epidemiology, and End Results program (SEER), we estimated breast cancer incidence rates and the rate of BCS by race in two periods (2000-2004 and 2013-2017). Relative survival analysis was based on patient-level data from 1998 to 2017. To be adjusted for baseline differences for different races, inverse probability weighting (IPW) models were stepwise performed.Results: From 2000-2004 to 2013-2017, both the breast cancer incidence (from 4.18 to 5.05 per 1000 white women) and the proportion of patients after BCS (from 55.5% to 59.9) were highest in whites than that of other races. Black individuals’ incidence (1.20 per 1000 black women or relatives 43.6% increased) and the BCR were increased most rapidly (6%) than other races. Asian or Pacific Islanders (APIs) were less likely to be diagnosed at a later stage and had the best prognosis than those of other races. After baselines fully adjusted, whites had the better Breast Cancer Specific Survival (BCSS) and Overall Survival (OS) than that of minorities (all p< 0.001).Conclusions: We identified the racial disparities of breast cancer incidence, BCR, and survival differences. We found increase trends of breast cancer incidence and BCR in minorities; however, we also identified the worse survival of minorities than that of whites, regardless of age, tumor stage, grade, and Luminal subtype.

scholarly journals A Critical Theoretical Approach to Cancer Disparities: Breast Cancer and the Social Determinants of Health

2021 ◽  
Vol 9 ◽  
Author(s):  
Sarah Gehlert ◽  
Darrell Hudson ◽  
Tina Sacks
Keyword(s):  
Breast Cancer ◽  
Black Women ◽  
Critical Race Theory ◽  
Social Determinants ◽  
Breast Cancer Mortality ◽  
Breast Cancer Incidence ◽  
Cancer Disparities ◽  
Individual Risk ◽  
Incidence And Mortality ◽  
Breast Cancer Disparities

Breast cancer is the most commonly experienced cancer among women. Its high rates of incidence and survival mean that a number of women will live it for periods of their lifetimes. Group differences in breast cancer incidence and mortality occur by race and ethnicity. For example, while white women are slightly more likely to be diagnosed with breast cancer, Black women are 40% more likely to die from the disease. In this article, rather than focusing the discussion on individual-level factors like health behaviors that have the potential to blame Black women and those living in poverty for their conditions, we view breast cancer disparities through the lens of Critical Race Theory, taking a historical perspective. This allows us to delve beyond individual risk factors to explore social determinants of breast cancer disparities at the population level, paying special attention to the myriad ways in which social factors, notably views of race and discriminatory public policies, over time have contributed to the disproportionate breast cancer mortality experienced by Black women. We suggest ways of addressing breast cancer disparities, including methods of training healthcare professionals and public policy directions, that include rather than marginalize Black and lower socioeconomic status women.

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