An estimated 232,340 new cases of invasive breast cancer and 39,620 breast cancer deaths are expected to occur among U.S. women in 2013. And according to a report released this week by the American Cancer Society, an increasing number of them will be black women.
Read on to see just how much breast cancer incidence rates are converging among white and African-American women, plus more notes on the black health chart this week.
Though the reason is unknown, researchers say breast cancer rates increased 0.2 percent among black women but remained stable among whites between 2006 and 2010, the latest time period assessed. Historically, white women have had the highest breast cancer incidence rates among women aged 40 years and older, and they still do with about 127 cases per 100,000 compared with 118 cases per 100,000 black women. However, incidence rates are now converging among white and African-American women, particularly among those aged 50 years to 59 years. "Although the incidence haven't declined, we have made strides in the effort to improve the survival rate. Death rates have declined by 34 percent since 1990. However, not all ethnic groups are enjoying this improved survival," Dr. Stephanie Bernik, chief of surgical oncology at Lenox Hill Hospital in New York City, told HealthDay. Breast cancer death rates have dropped by 34 percent since 1990 in all racial/ethnic groups except American Indians/Alaska Natives, while African-American women continue to have the poorest breast cancer survival of any racial/ethnic group. In June, a JAMA study showed that black women are less likely to survive a breast cancer diagnosis within five years because they undergo fewer screenings, have poorer health at the time of diagnosis and have more advanced disease by the time the cancer is found. Authors of of the ACS report also noted that reproductive history and obesity are more strongly linked to ER-positive breast cancer, the form of the disease more common among white women, while lower socioeconomic status has been linked to raised risk for ER-negative breast cancer, which is more common among African Americans.
A report published in the October issue of the journal Social Science & Medicine shows "strong and consistent relationships between racial discrimination and a range of detrimental health outcomes such as low self-esteem, reduced resilience, increased behavior problems and lower levels of well-being" among kids 12 to 18 years old. "We know that children who experience poor health and well-being are less likely to engage in education, employment and other activities that support them to lead healthy and productive lives, and to participate meaningfully in the community," lead researcher Naomi Priest, of the University of Melbourne in Australia, said in a news release. Most of the racism experienced by children and teens involved discrimination by other people, rather than institutional or systemic racism, the review noted. Additionally, the review also revealed an increased risk of poorer birth outcomes among children whose mothers experienced racism during pregnancy.
Americans in the highest socio-economic groups have a 13 percent greater chance of surviving a kind of stroke known as a subarachnoid hemorrhage (SAH) than those in the lowest socio-economic groups, a study published in the October issue of the journal Stroke has found. Using data from 31,631 U.S. patients and 16,531 Canadian patients, researchers discovered that patients in the top 25 percent of neighborhood income were at significantly less risk of dying from SAH than those in the bottom quarter of neighborhood income. In the lowest income levels (a group comprised most of African Americans), 23 per cent of SAH patients died, compared to 20 per cent of patients at the highest incomes. "Insurance status has been shown to significantly impact outcomes for patients with SAH, with worse outcomes more likely to occur among patients who are inadequately insured," said study author, Dr. Loch Macdonald. "Better insured patients are more likely to live in wealthy neighborhoods and have better access to timely, high-quality specialized care, which has been shown to be critical to improved outcomes after SAH." In Canada, social and economic status had no bearing on mortality rates for SAH, the report states, suggesting that the country's universal, publicly funded health insurance coverage may play a role in improving outcomes among patients in lower socioeconomic groups.
The incidence of preterm delivery is 60 percent higher in African American women, according to Dr. Xinhua Chen, of the Department of Obstetrics and Gynecology at RowanSOM who just received a $1.8 million federal grant to determine the role diet plays in the higher incidence of preterm delivery in this group. The five-year study, which is being funded through a grant from the National Institute on Minority Health and Health Disparities, aims to look at how modifying dietary fat may be an inexpensive and essential tool in reducing the significant ethnic disparity in adverse pregnancy outcomes. “Dietary fat intake can influence the levels of free fatty acids (FFAs) in the blood, which, in turn, can alter vascular inflammation, an underlying cause of many health problems, including type 2 diabetes and cardiovascular disease," Chen said in a university release. "Our study will be the first to examine if maternal FFA-related vascular inflammation is a factor in the higher rate of preterm delivery and other pregnancy complications among minority women.”