Researchers have long puzzled over why African-American women have higher death rates from breast cancer, even though white women have the highest incidence of the disease. I came across an interesting interview with Dr. Sherri Sheinfeld Gorin, a doctor at Columbia University Medical Center that discusses a recent study of nearly 50,000 Medicare recipients, age 65 and older. The study found that black women have the longest delays in getting diagnosed with breast cancer, which could be a related piece of the puzzle.
Here are some of the highlights of the study:
African American women were 40 percent more likely to have a diagnostic delay beyond two months, and were 64 percent more likely to have a treatment delay beyond one month compared to white, Hispanic or women of any other race. It’s not clear from the study whether the delay is due to patient delay or doctor delay.
There is an implication that a one- or two-month wait for treatment leads to worse outcomes-- tumors may be larger or have spread to lymph nodes or to other parts of the body.
Recommendations that resulted from the study include making health care plans and medical centers more accountable for the time between screening and diagnosis, and diagnosis and treatment, having more trained radiologists and other skilled professionals in poor communities, and having doctors develop better systems for tracking follow-up to the mammograms.
Is it racism? Dr. Gorin says the delays are not “overt discrimination against black women,” as there are other factors leading to the delays such as black women who sometimes delay treatment because they distrust medical professionals, or are fatalistic about breast cancer so may not seek further treatment. Still, it seems clear from the study that more needs to be done to help African-American women with breast cancer overcome bad outcomes.
Published On: December 14, 2006