Cancer is a group of diseases characterized by uncontrolled growth and spread of abnormal cells. If the spread is not controlled, it can result in death. Cancer is caused by both external factors (tobacco, infectious organisms, poor nutrition, chemicals, and radiation) and internal factors (inherited genetic muta- tions, hormones, immune conditions, and mutations that occur from metabolism). These causal factors may act together or in sequence to initiate or promote the development of cancer. Ten or more years often pass between exposure to external factors and detectable cancer. Most cancers are treated with surgery, radiation, chemotherapy, hormone therapy, biologic therapy, targeted therapy, or some combination of these.
African Americans have the highest death rate and shortest survival of any racial and ethnic group in the US for most cancers. The causes of these inequalities are complex and are thought to reflect social and economic disparities more than biological differences associated with race. Socioeconomic disparities include inequities in work, wealth, income, education, housing and overall standard of living, as well as barriers to high-quality cancer prevention, early detection, and treatment services.
The 5-year relative survival rate for breast cancer diagnosed in 2002 – 2008 among African American women was 78%, compared to 90% among whites. This difference can be attributed to both later stage at detection and poorer stage-specific survival among African American women. Only about half (51%) of breast cancers diagnosed among African American women are diagnosed at a local stage, compared to 61% among white women. Within each stage, 5-year survival is also lower among African American women than whites overall (60% versus 69%).
Studies have documented unequal receipt of prompt, high-quality treatment for African American women compared to white women.6, 44 – 46 There is also evidence that aggressive tumor characteristics are more common in African American than white women. 30, 33 Other studies suggest factors associated with socioeconomic status may influence the biologic behavior of breast cancer.47, 48 Poverty likely influences disease pathology and genetic markers of disease through lifelong dietary and environmental exposures, physical activity, and reproductive behaviors.
A woman’s best overall preventive health strategy is to reduce her known risk factors as much as possible by avoiding weight gain and obesity (for postmenopausal breast cancer), engaging in regular physical activity, and minimizing alcohol intake. Women should consider the increased risk of breast cancer associated with combined estrogen and progestin menopausal hormone therapy when evaluating treatment options for menopausal symptoms. More information about breast cancer is available in the American Cancer Society publication Breast Cancer Facts & Figures, available online at www.cancer.org.
Cancer facts and figures for African Americans 2013-2014