Socio-economic Factors Likely to Impact Breast Cancer Diagnosis, Treatment and Outcome Disparities for Certain Ethnic/Racial Groups
Women from certain racial and ethnic sub-groups within the United States show significant differences when it comes to diagnosis, treatment and outcome of breast cancer, and socio-economic factors may be responsible, a recent study from the Fred Hutchinson Cancer Research Institute in Seattle says.
?The study from the Fred Hutchinson Cancer Research Center underscores the need to increase funding of programs related to the breast health and breast cancer needs of women from racial and ethnic minorities, especially those from key immigrant communities relatively new to this country,? said Rebecca Garcia, Ph.D., vice president of health sciences for the Susan G. Komen Breast Cancer Foundation. ?The U.S. continues to become increasingly racially and ethnically diverse, but breast cancer remains an ?equal opportunity? disease,? Dr. Garcia said. ?The Komen Foundation is deeply committed to investing in research and community-based programs designed to reduce the racial and ethnic disparities that exist in breast cancer diagnosis, treatment and mortality.?
The Hutchinson study, which appeared in the January 13 issue of Archives of Internal Medicine, concluded that socio-economic factors were largely responsible for the apparent disparities among the groups studied. Other factors, such as cultural practices, dietary habits and possibly genetics, likely play a less prominent role, said Christopher Li, M.D., PhD.
Dr. Li?s group found that immigrant populations relatively new to the United States, such as Vietnamese and Korean, suffered greater disparities than did Japanese immigrants, many of whom have been here longer. Language barriers and unfamiliarity with modern medicine and healthcare access led to breast health disparities in newer immigrant groups. The study found that women from certain racial/ethnic sub-groups, including Mexican, Puerto Rican, Filipino, South and Central American, Indian-Pakistani, and Hawaiian, showed a greater statistical tendency to be diagnosed with late-stage cancers, to receive inappropriate treatment and to have relatively poorer survival rates when compared to non-Hispanic Caucasians.
Korean and Vietnamese women also showed a trend toward late-stage diagnosis; however, they tended to receive appropriate care. Japanese and Chinese women, overall, tended to show better survival rates, according to the study. It?s important to note that the mortality rates in the study were from any cause, not only breast cancer. Further studies on the impact of socio-economic status and access to care are needed to confirm the study findings.
?Additional evidence would help our ongoing efforts to advocate for improved access and quality of care for all women,? said Dr. Garcia.
Over the last decade alone, the Susan G. Komen Breast Cancer Foundation?s national Award and Research Program has funded over $7.3 million for initiatives focusing on the breast health needs of African American, Hispanic, Native American, and Asian populations.
The Komen Foundation is a recognized leader in funding breast health initiatives for minorities and other targeted population groups, with an emphasis on funding qualified, community-based needs identified through its 118 nationwide Affiliates. Over the last decade, Komen Affiliates have granted over $21 million toward programs that target the breast health and breast cancer needs of ethnic and racial minority populations.
Examples of Komen initiatives keyed to recent immigrant populations include the issuing of breast health education materials in culturally appropriate formats; funding of ?patient navigator? and translator programs to assist with language and cultural barriers to medical care; screening and outreach programs for under-insured and un-insured women; health fairs; Komen?s bilingual breast care Helpline (1.800.I?M AWARE®); and the funding of domestic and international conferences, symposia and studies that focus specifically on the types of breast health disparities and quality-of-care issues underscored in the Fred Hutchinson study.
In 1999, the Komen Foundation formed its African American National Advisory Council (AANAC), to make informed and culturally sensitive decisions on programs, materials, public policy and grants funding. Soon after, Komen formed its National Hispanic Latina Advisory Council to help address breast health needs within this minority population. This spring, the Foundation will introduce the members of its newest advisory group, dedicated to focusing on the breast health needs of Asian Americans and Pacific Islanders.
The Hutchinson study reinforces results from a Komen-funded needs assessment conducted in 2002 by California Family Health Council, Inc. Results from the study show that considerable work remains to be done in raising the general knowledge level about breast cancer among minority populations. The results of the Komen-funded needs assessment will be issued later this year.