Nonadherence to Treatment May Contribute to Higher Mortality for African-American Women
Susan G. Komen® today hailed new findings from Komen-funded research that found a potential driver for why African-American women diagnosed with breast cancer are more than 40 percent more likely to die than white women. According to a report published recently in the Journal of the National Cancer Institute by Komen Career Catalyst Research grantee, Dr. Katherine Reeder-Hayes, Komen Scientific Advisory Board Member Lisa Carey and colleagues, black women with hormone-receptor positive (HR+) breast cancer were more likely than white women to not take their endocrine therapy as prescribed.
For women with HR+ breast cancer, taking endocrine therapy pills (like tamoxifen or aromatase inhibitors) for up to 10 years can reduce the risk of cancer recurrence and cancer-related death.
Using data from the Komen-funded Carolina Breast Cancer Study, a multi-phase study designed to examine the causes of breast cancer in Black/African-American and white women in North Carolina, the researchers found 13.7 percent of black women diagnosed with HR+ breast cancer reported not taking endocrine therapy pills or missing more than two pills in a two-week period. By comparison, only 5.2 percent of white women reported missing doses. Black and white women stopped taking prescribed endocrine therapy at a similar rate. Overall, about one in four black women surveyed reported that they are not taking their endocrine therapy as prescribed, and thus are not receiving its benefits.
Importantly, the study also identified several reasons for treatment nonadherence that are different between African-American and white women. Differences in their beliefs about the risk that their cancer will return and the ability of endocrine therapy to protect them from a recurrence, as well as differences in how treatment decisions are made between the doctor and patient and the burden of side effects appear to be driving the difference in nonadherence.
“Our Scientific Advisory Board estimates that about a third of all breast cancer deaths could be prevented without a single new breakthrough in research by just ensuring people receive (and stay with) the care they need,” said Victoria Wolodzko, Komen’s Senior Vice President of Mission. “These findings underscore the importance and impact of culturally appropriate patient education, and patient-doctor communication and shared decision- making to reducing disparities in breast cancer outcomes.”
These latest findings are part of Komen’s long-term commitment to research that will lead to a reduction in mortality from breast cancer. Komen recently announced its newest investments in breakthrough research, focused primarily on metastatic and treatment resistant breast cancers.