A recent report in Scientific Reports compared racial disparities among Black and White women with breast cancer. Many studies have established health disparities, including racial differences in cancer incidence and treatment efficacy. Additionally, this study adds an important dimension to our understanding of health disparities by evaluating differences in treatment-induced side effects between Black and White women.
The retrospective cohort study included over 17,000 women with breast cancer diagnosed between 2005 and 2022. All women in the study came from non-Hispanic backgrounds, 82% of whom were White. Participants received various treatments, including surgery, radiation, chemotherapy, endocrine (hormonal) therapy, or immunotherapy. Some patients had more than one therapy in their treatment regimen. The study investigated the onset of treatment-related side effects, including chemotherapy complications, cardiovascular toxicities, immune-related adverse events, psychological effects, or cognitive decline (such as dementia).
Black women were more likely to have a smoking history and more significant comorbidities. Additionally, Black women had a higher probability of Stage IV breast cancer more often, indicating late diagnosis and metastatic spread.
The study identified some differences in treatment regimens between Black and White participants. Compared to Black women, White women had a higher probability of having breast cancer surgery or receiving hormonal therapies. On the other hand, Black women were 40% more likely to receive adjuvant radiation therapy than White women.
When considering treatment-related side effects, the researchers found White women had a 19% higher risk of psychological issues, while Black women exhibited a 30% greater risk of cognitive impairments.
Several factors contributing to the disparities seen between Black and White women with breast cancer exist based on previous evidence-based studies. For example, Black women tend to have higher rates of unemployment and financial insecurity. They are more likely to live in neighborhoods farther away from health clinics than White women. Additionally, previous studies have demonstrated that, compared to White women, Black women experience longer delays to treatment and more often receive treatment regimens that stray from accepted guidelines.
The authors confirm racial disparities in breast cancer and identify differences in the frequency and type of side effects experienced by Black and White women. Further, the authors relate the discrepancies observed to socioeconomic factors and complications in accessing care.
Sources: Br J Cancer, Am Soc Clin Oncol Educ Book (Osarogiagbon), Scientific Rep, Am Soc Clin Oncol Educ Book (Stringer-Reasor), JAMA, J Clin Oncol