African-American Women: Breast Cancer More Deadly?
Women & Breast Cancer: Ongoing Research continued...
She took into account such factors as age, tumor features, stage when diagnosed, and treatments.
Asians were 40% less likely than whites to die of breast cancer during the follow-up.
African-Americans were nearly 50% more likely than whites to die of breast cancer during the follow-up.
That first three years after diagnosis, Warner says, were especially risky.
When she took into account age and tumor features, she found no differences between African-American and white women for certain tumors, including estrogen receptor-negative tumors. These are typically more aggressive than others.
Warner can't fully explain the findings.
"We've put everything we can think of in our model," she says, as a way to explain survival differences. "We still find persistent differences in survival."
"We thought it might have something to do with treatment differences, but we accounted for disparities and the differences persisted," Warner says.
However, she says, there could still be some treatment differences not fully accounted for that could help explain the higher death risk.
"On average, black women in our study were diagnosed at a later stage," she says.
Body mass index at diagnosis plays a role in survival, she says. Higher BMIs are linked with lower survival. "We see differences starting at [a BMI of] 25," she says. A BMI of 25 is termed overweight.
The biggest survival differences, she says, are seen at BMIs of 30 and higher, termed obese, Warner says.
African-American Women & Breast Cancer: Perspective
"Their findings are certainly consistent with previous work examining racial disparities in breast cancer mortality," says Swann Arp Adams, PhD, assistant professor and associate director of the Cancer Prevention and Control Program at the University of South Carolina, Columbia.
Adams' study on racial disparities was published in the journal Cancer earlier this year. She, too, found that African-American women had lower survival after breast cancer than other ethnicities.
However, Adams says, it's not all gloom and doom.
Many public health programs, she says, are trying to improve the outlook. "Here in South Carolina, the Best Chance Network, which is a part of the National Breast and Cervical Cancer Early Detection Program, provides free mammograms and Pap smears to income-eligible women."