Risk Factors For Breast Cancer - Racial and Socioeconomic Factors

Racial and Socioeconomic Factors

Incidence and mortality vary with race and social status. Incidence rises with improving economic situation, while mortality is tied to low economic status. In the US incidence is significantly lower and mortality higher among black women and this difference appears to persist even after adjustment for economic status. It is currently unclear if significant racial differences in incidence and mortality persist after adjustment for economic status between women of white, Hispanic and Asian origin in the US.

Several studies have found that black women in the U.S. are more likely to die from breast cancer even though white women are more likely to be diagnosed with the disease. Even after diagnosis, black women are less likely to get treatment compared to white women. Scholars have advanced several theories for the disparities, including inadequate access to screening, reduced availability of the most advanced surgical and medical techniques, or some biological characteristic of the disease in the African American population. Some studies suggest that the racial disparity in breast cancer outcomes may reflect cultural biases more than biological disease differences. However, the lack of diversity in clinical trials for breast cancer treatment may contribute to these disparities, with recent research indicating that black women are more likely to have estrogen receptor negative breast cancers, which are not responsive to hormone treatments that are effective for most white women. Research is currently ongoing to define the contribution of both biological and cultural factors.

Part of the differences in incidence that is attributable to race and economic status may be explained by past use of hormone replacement therapy