Does Race or Ethnicity Affect Breast Cancer Risk?
All women should be aware of their risk for breast cancer. It can affect women of every age, race, and ethnic group. However, the rates of developing and dying from breast cancer vary among different racial and ethnic groups.
According to the National Cancer Institute, white, non-Hispanic women have the highest overall incidence rate for breast cancer among U.S. racial/ethnic groups. Native Americans and native Alaskans have the lowest rate. Among women under age 40, African-American women have a higher incidence of breast cancer than white women. African-American women also have the highest death rate from breast cancer. Native Americans and native Alaskans, along with Asian-American women, have the lowest death rate.
Several factors have been found to affect the breast cancer incidence and death rates among racial and ethnic groups. Differences in certain lifestyle behaviors -- such as diet, exercise, smoking, and alcohol use -- can influence the risk of many diseases, including heart disease and breast cancer.
The higher death rate from breast cancer among African American women has been linked to the stage, or extent, of the cancer at the time of diagnosis. Studies show that African-American women tend to seek treatment when their cancers are more advanced and there are less treatment options. A higher death rate in this population may also in part be due to a higher rate of triple negative (hormone receptor negative, HER2-negative) breast cancers diagnosed in African-American women.
In addition, a higher percentage of African-Americans and Hispanics lack a usual source of health care, such as a primary care provider. Having a primary care provider increases the chance that a person will receive appropriate preventive care -- including routine check-ups and screenings -- that can detect disorders at an early stage.
There also are various factors that may contribute to the lower rates of routine and preventive health care among minority populations, including:
- Socioeconomic factors. These include income level, lack of transportation, and lack of access to health insurance or health care facilities, including screening programs.
- Language and communication barriers. These barriers can interfere with a person's ability to discuss health concerns and develop trust in a primary care doctor.
- Education about or understanding of health care risks and symptoms. Women who are not aware of disease risks and symptoms are more likely to wait to seek treatment until they are in pain or their symptoms interfere with daily tasks.
- Cultural practices and expectations. In some cultures, women may turn to traditional or "folk" remedies before seeking treatment from a physician.
- Cultural or religious beliefs related to health and health care. Strong beliefs in healing and miracles, as well as distrust of the health care system may keep some people from participating in routine preventive care.
There continues to be an enormous need for more education and resources to reach women -- particularly minority women -- with the message of breast cancer screening and prevention. Prevention and early detection of breast cancer are important for all women. For those who are at high risk, careful monitoring and follow-up care with a primary care provider are especially vital.