Higher death rate is largely due to insurance issues, but tumor types sometimes play a role, study finds
MONDAY, Oct. 16, 2017 (HealthDay News) -- Differences in insurance are a major reason why black women are more likely to die of breast cancer than white women in the United States, a new study contends.
"We found that differences in insurance explained one-third of the total excess risk of death in non-elderly black women compared to white women diagnosed with early stage breast cancer, while differences in tumor characteristics explained approximately one-fifth of the excess risk," lead study author Ahmedin Jemal, of the American Cancer Society (ACS), and colleagues wrote.
In 2014, breast cancer death rates were 41 percent higher among black women than among white women in the United States, the researchers said.
To learn more about this disparity, the investigators looked at information on more than 550,000 non-elderly women with early stage breast cancer.
Black women were more likely to be uninsured or have Medicaid coverage than white women (23 percent versus 8 percent), the findings showed. In addition, black women were more likely to have tumors that were larger, more advanced and hormone receptor-negative.
If a tumor is hormone receptor-positive, that means its growth is fueled by certain hormones, according to the ACS. There are medications that can lower hormone levels that help keep these cancers at bay. Compared with hormone receptor-positive cancers, hormone receptor-negative cancers tend to grow faster and have fewer treatment options.
Among women with hormone receptor-positive tumors, black women were twice as likely to die as white women. Insurance accounted for 37 percent of that increased risk among black women, followed by tumor characteristics (23 percent), other health conditions (11 percent), and treatment (5 percent), the researchers said.
Among women with hormone receptor-negative tumors, black women had a 50 percent higher risk of death than white women did. Insurance accounted for 34 percent of black women's increased risk, followed by tumor characteristics (22 percent), other health conditions (4 percent), and treatment (4 percent).
"Health policy makers should ensure that the benefits of important scientific advances in prevention, early detection and treatment of breast cancer are made available to all women, especially black women, who experience an undue share of the mortality burden from this disease," the study authors said.
Equalizing access to care for non-elderly black women could help reduce the disparities in the death rates of women diagnosed with breast cancer, Jemal's team concluded.
The study was published Oct. 16 in the Journal of Clinical Oncology.
The U.S. National Cancer Institute has more on breast cancer.