Black Women with Breast Cancer Still Have Higher All-Cause, Cancer Mortality Risk Than White Women

Racial disparities in breast cancer mortality have been previously reported, and according to a new study, these disparities still persist, with black women at a greater risk for all-cause and breast cancer–specific mortality compared to white women.

“Socioeconomic and treatment factors contribute to diagnosis of early-stage (local-stage) breast cancer, as well as excess deaths among African American women,” the study authors explained. “We evaluated socioeconomic and treatment predictive factors for early-stage breast cancer among African American women compared to Caucasian women.”

They retrospectively reviewed data from the Surveillance, Epidemiology, and End Results (SEER) Program spanning 2007 through 2016. Women aged ≥20 years diagnosed with breast cancer primary tumors during the study period were eligible for inclusion. In addition to factors associated with early-stage breast cancer, the researchers also evaluated risk factors for all-cause and breast cancer–specific mortality.

Final analysis included 547,703 patients. Compared to white women, black women were more likely to be diagnosed with late-stage cancer and have larger tumors at diagnosis; they were less likely to undergo cancer-directed surgery but more likely to receive chemotherapy. Women with insurance had a greater likelihood of receiving an early-stage diagnosis and having smaller tumors (P<0.05). For women diagnosed with early-stage cancer, there were no correlations between education level, poverty level, and household income and racial or socioeconomic disparities. When adjusting for demographic, socioeconomic, and treatment factors, black women, compared to white women, had higher risks for all-cause mortality (hazard ratio [HR]=1.18; 95% confidence interval [CI], 1.16 to 1.21) and breast cancer–specific mortality (HR=1.22; 95% CI, 1.19 to 1.25).

The results of the study were published in the Journal of Racial and Ethnic Health Disparities.

“In this population-based study using the most recent SEER data, African American women with breast cancer continued to exhibit higher all-cause mortality and breast cancer–specific mortality compared to Caucasian women,” the researchers summarized.

Black Women Have Poorer Cervical Cancer Outcomes, Too

It’s not only breast cancer that black women have a greater mortality risk for. Black women with cervical cancer had worse five-year relative survival rates compared to white women in a study of patients in Alabama. This study also used SEER database data, encompassing 3,484 black women and 21,059 white women from 2004 to 2013.

The relative survival rate for white women in urban counties, compared to black women in urban counties, was significantly higher (77.8%; 95% CI, 70.7% to 83.3% vs. 72.7%; 95% CI, 55.4% to 84.2%). Black women in Black Belt counties had a significantly lower relative survival rate than their white counterparts (73.2%; 95% CI, 47.4% to 87.8% vs. 83.8%; 95% CI, 74.5% to 89.9%).

In other rural counties, white patients had a slightly lower relative survival rate (83.7%; 95% CI, 79.9% to 86.8%) than black women (83.8%; 95% CI, 74.2% to 90.1%). However, the relative survival rate was still considered better for white women because the sample size was larger and variability lower for white women.