African American women
For African American women in the United States, the chance of getting breast cancer is lower than for white women, but the risk of dying from breast cancer is higher (Figure 1.2). One possible reason for this difference in survival is that, in the past, African American women were less likely than white women to get regular mammograms [59,60]. This increased the chances of being diagnosed with a later stage breast cancer. In 2003, African American women and white women had the same rates of mammography use (70 percent), but disparities in survival remain [61]. Currently, African American women have a 37 percent higher rate of breast cancer mortality than white women [61]. Some studies have found that inadequate follow-up care after an abnormal mammogram among African American women may be a factor in this difference [62,63]. However, access to care alone cannot explain the survival gap. Even after taking into account differences in socioeconomic status, screening rates and access to care, African American women still have shorter survival times and more advanced tumors at diagnosis [64-67].
For more on factors that may impact breast cancer risk and survival among African American women, visit the Risk Factors section.
Other populations
Most other ethnic groups, including Hispanic/Latina, Asian American, Pacific Islander and Native American women, have lower rates of breast cancer than white or African American women [60,68]. However, the number of these women getting regular breast cancer screening is also low. With less screening, women may be getting diagnosed later, making their chances for survival lower [60,64,69-71].
Likewise, some research shows that lesbians and bisexual women may not get the primary care and regular mammograms they need [72,73]. This may be due to issues like lack of insurance, financial hardship and past experiences of discrimination and insensitivity from health care providers [74].
More community education may help women understand the value of regular screening. Education addressing some of the common negative beliefs and attitudes about mammography and the medical system may improve screening rates. Greater sensitivity on the part of medical providers working with women from different communities is also important. Moreover, improving access to mammography and primary care and removing language barriers to screening (especially for poor and uninsured women) are crucial to increasing screening rates [75].
Updated 10/05/09
