Gap in breast cancer mortality rates between Black and white women has narrowed

Black women still have twice as many breast cancer deaths than white counterpartsBottom line: Since 1990, breast-specific mortality rates for women with breast cancer have declined more in Florida than among white women. Despite these advancements, Black women still have twice the 5- and 10-year mortality rates than non-Hispanic whites.The Journal in which the study was published: Cancer Epidemiology Biomarkers & Prevention, a journal affiliated with the American Association for Cancer Research.Robert Hines PhD, MPH is the author. He is an associate professor of population health sciences at University of Central Florida College of Medicine.Background: Over the past few decades, breast cancer incidence in Black women has been lower than for white women. Additionally, Black women are more likely to have advanced disease. Hines attributes this to the increased incidence of breast cancer in Black women over time to better surveillance.Hines explained that breast cancer mortality rates started to fall around 1990 due to improved screening and new therapeutics. However, the decline was much slower for Black women.Hines stated that breast cancer mortality disparities have been increasing since the 1980s and that the alarming fact has grown over the years. Although there has been significant investment in decreasing or eliminating these disparities we wanted to determine if it was effective. These initiatives have mostly focused on improving screening education and access for socioeconomically disadvantaged groups and racial or ethnic minorities.The Study was Conducted by Hines and coworkers. They obtained records from Florida Cancer Data System containing information about more than 250,000 breast cancer patients between 1990 and 2015. The sample included female patients who identified as non-Hispanic black (79.5%), Hispanic Black (10.5%), Hispanic white (9.7%) or Hispanic Black (0.3%). Researchers analyzed the cumulative breast cancer death rate and relative hazard rates over five- and 10-years for each group. The researchers grouped patients according to year of diagnosis: 1990-1994; 1995-2004; and 2005-2015.Results: Researchers discovered that mortality declined gradually between 1990 and 2015. Non-Hispanic white women's 10-year mortality fell from 20.6 percent during the first five years (1990-1994), to 14.0 percent over the last time period (2010-15). Non-Hispanic Black women's 10-year mortality fell from 36.0 percent down to 25.9%.Hines was both surprised and encouraged by the fact that there were no significant differences in mortality rates over the past 10 years. Hines points out that Black women still have twice the 5- and 10-year mortality rates than non-Hispanic-white women.These results suggested possible reasons for the continued disparities. The researchers found that the 10 year relative rate of breast-cancer mortality in Black women decreased to 20% after normalizing the data on mortality. This was from a group of women who had been diagnosed with the disease before normalization.Author's comments: "Over the last three decades, there has been an improvement in breast-cancer survival rates for all women, especially for minorities. This is encouraging. Hines stated that non-Hispanic Black women had twice the rate for breast cancer deaths in the latest time period than non-Hispanic White women. We should celebrate the achievements we make, but there is still much to do to ensure equitable outcomes for breast cancer patients.Hines and his team will be looking for reasons why the disparities persist. This will help to guide future initiatives to close the gap. Hines stated that "to have the greatest impact, we must identify the individual factors that are most accountable."Study Limitations: This study has limitations. Incomplete data was not available for some patients at certain time points. Patients who identified as other races than black or white, or ethnicities other than Hispanic were not included in the study.Disclosures & Funding: The University of Central Florida College of Medicine funded this study. There are no conflicts of interest among the authors.###