A study on racial disparities in breast cancer published in the Journal of the National Cancer Institute challenges the assumption that receptor status is the primary reason African-Americans have more agressive forms of breast cancer.
Researchers discovered that black patients with breast cancer had worse survival than white patients, despite identical treatment and follow-up and irrespective of hormone receptor status. They say this shows that African-American women may get a different type of cancer altogether–something that cannot be entirely explained as hormone-receptor negative or triple-negative. And this cancer is highly aggressive. The research also casts doubt on the theory that lower survival rates among African-Americans for certain cancers are due solely to factors such as poverty and poor access to quality health care.
The study used data from the National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) program on 244,786 women diagnosed from January 1990 through December 2003 and followed through December 2004.
According to an article from the National Institutes of Health, researchers found that:
…regardless of ER status, black women with breast cancer were still more likely to die of the disease than white women. This disparity remained even when the researchers adjusted for age at diagnosis, stage and grade of the tumor, year of diagnosis, and socioeconomic status. When the researchers examined the hazard rate trends in black and white women, they noticed that the largest differences occurred in the first three years after diagnosis in both ER- and ER+ tumors.
Why do blacks have more aggresive tumors, even allowing for receptor status? Researchers suggest the environment and genetics may both be an issue. The NIH added:
This analysis confirmed that, despite the higher incidence of ER- tumors (which are associated with a less favorable prognosis) among black women, the differences in survival outcomes between the two populations were driven largely by differences in the hazard rate as opposed to differences in estrogen-receptor status.
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