Breast cancer, the most commonly diagnosed cancer in women, is an important public health issue in Canada. It is the second leading cause of cancer-related death in women, and about 1 in 9 women are expected to develop this disease during her lifetime.
These facts are concerning, but we rarely talk about the role of race, poverty and the social determinants of health when it comes to breast cancer. A recent article in The New York Times highlighted how Black Americans have higher death rates due to cancer than any other racial or ethnic group. It described Black women in America and their battle with breast cancer explaining how they are 40 percent more likely to die from this disease than White women. The reasons for this gap are delayed diagnosis and inequitable access to effective treatment and timely follow-up care. Other reasons believed to play a role in this difference include racial differences in tumour biology, knowledge about breast cancer among racialized communities, and socio-economic factors. In Canada, although it’s unclear what the exact racial differences in breast cancer outcomes are, due to the lack of ethnic/racial data, we do know that First Nations women have a higher chance of getting diagnosed with a later-stage and more serious form of breast cancer than other Canadian women. We also know that women living in poverty have a lower chance of survival than their more affluent counterparts. There is sufficient evidence that shows racial and ethnic differences have a significant impact on screening uptake.
Our recent report Breast Cancer Screening in Racialized Women describes disparities not only in screening but also in breast cancer outcomes (incidence and deaths), and the factors that contribute to these inequitable outcomes across the breast cancer continuum – from screening and prevention to treatment.
Although achieving equity in breast cancer screening is very important, it is critical to understand that what happens after screening is equally important, if not more so. Therefore embedding equity throughout the breast cancer care continuum (in quality and access) should be the real focus moving forward.
How? Our report sets out solutions including collecting data to determine which populations are being underserved, what their specific needs are and the importance of targeted programs and services.