I was diagnosed with breast cancer 5 months ago. During that time, I learned a lot about cancer, which affects one in eight women in this country.
My case felt unusual at first. I had just turned 40 and had no family history. And genetic testing came back normal.
As you know, you look young and healthy.
But the reality is that more people are being diagnosed with breast cancer today.
The American Cancer Society recently reviewed 10 years of data and found that the incidence of breast cancer is increasing every year, and the rate of increase is faster in women under 50.
But within that harsh truth lies good news.
Breast cancer is the most heavily funded cancer research in the country. Thanks to advances in testing and treatment over the past 35 years, mortality rates have decreased by 44%.
But these advances benefit some groups more than others.
When broken down by demographics, the biennial report shows an increase in Asian American and Pacific Islander women and a long-standing disparity in survival among black women.
Breast cancer rates among black women
Black women have long been more likely to die from breast cancer than other races and ethnicities.
They have the lowest survival rate at any stage of breast cancer and are 38% more likely to die than white women, who have the highest incidence of breast cancer.
“The unfortunate statistic that there is a 40% mortality difference between white women and black women has existed for more than 40 years,” said Breast Cancer Surgeon and researcher at City of Hope, a national cancer treatment organization. says Dr. Veronica Jones. “Despite all the progress, it still remains.”
Dr. Jones explained that although breast cancer is a leader in research funding, the field is playing catch-up in underrepresented communities.
“I think one of the ways we got here is by eliminating diversity in clinical trials,” she says. “So much of what we know about breast cancer has been studied in roughly homogeneous populations.”
Another factor: Not all types of breast cancer have equal survival rates. For example, triple-negative breast cancer is more aggressive and grows rapidly, making it more likely to be diagnosed at a later stage. Black women have the highest rate of this type of illness, accounting for 1 in 5 women compared to 1 in 10 for other women.
“Some are what we think of as interval cancers, meaning they can occur between mammogram exams. And triple-negative breast cancers tend to be that type,” says Jones. the doctor explained. “The challenge with that is that even if they do attend, it’s often later just because they were missed.”
Now, a new wave of research is taking place, and Dr. Jones is part of that shift, exploring the social, environmental, and patient experiences that not only increase breast cancer risk but also potentially create barriers to screening and care. We are investigating a myriad of factors. lifestyle.
“Ancestry, genomic markers, all these different factors play a role in why disparities exist,” Dr. Jones added. “For example, we are currently studying how social determinants of health (like the environment in which people live) affect gene expression, and how that affects outcomes. We can’t look at them in isolation anymore. We’re really looking at all aspects of the individual and how that can perpetuate inequality in their lives. .”
It’s also often forgotten that anyone can get breast cancer, and the barriers can be even higher for other genders. Black men have the highest incidence of breast cancer and highest death rate of all racial and ethnic groups.
“There’s a lot of talk about how to increase equity across the board and raise awareness of what kinds of testing are available to all people and how to make it more accessible both practically and culturally. efforts are being made,” he said. Jones.
She stressed that people need to know their breast cancer risk. If there is a family history of aggressive breast cancer, patients may be eligible for enhanced screening every six months instead of annually.
Listen to Dr. Veronica Jones’ full conversation on Insight here.
Breast cancer rates among AAPI women
In the early 2000s, Asian American and Pacific Islander women had the lowest breast cancer rates of all races and ethnicities.
Looking back at the most recent 10 years of available data, breast cancer rates among AAPI women are currently increasing the fastest, at 2.6% per year between 2012 and 2021.
“Our breast cancer screening guidelines are really sketchy. When you think about it, they’re just based on family history and age,” says Dr. Scarlett Lynn Gomez, an epidemiologist at the University of California, San Francisco. “And they certainly don’t take into account the potentially higher risks seen in the latest data.”
Dr. Gomez is the principal investigator of the first long-term cancer study in Asian Americans. She has seen this increase, and the most dramatic increase has been in women under 50.
“The increase in breast cancer is increasing at a steady rate,” she explained. “The latest data points show that these young Asian American Pacific Islander women have the highest incidence of breast cancer of any racial and ethnic group. That is certainly very concerning. It’s a good trend.”
Dr. Gomez is working to find out why. One problem is that Asian Americans and Pacific Islanders are a very diverse group, yet they are lumped together in research.
“This statistic shows the situation of the most dominant group,” she explained. “For much smaller groups, they cannot be represented. Their data is effectively hidden and erased.”
This distorted picture has historically led to a lack of research funding.
“Thus, these statistics tend to paint a rosy picture regarding cancer incidence and mortality rates for Asian Americans overall,” Dr. Gomez said. “That’s why the National Institutes of Health, the largest federal funder, and the National Cancer Institute within it, typically do research on cancer disparities among Asian Americans because of the recognition that the burden of cancer is so low. has not provided funding.”
Dr. Gomez is part of a new study that is chipping away at this understudied group, finding that breast cancer rates are also increasing in certain countries in Asia.
“One modeling analysis estimates that if current rates of growth continue, Asian women will soon have the highest breast cancer rates in the world,” Dr. Gomez said. “This is because the rate of Westernization is so fast. More women are entering the labor force, which means they are delaying childbearing, having fewer children, and have fewer opportunities to breastfeed.” We are seeing the loss of traditional cooking methods and traditional food types that families would normally consume.
Dr. Gomez also studies the role stress plays.
“We hear from patients who have been diagnosed with breast cancer that stress is very important to them. That they believe this is a major risk factor. They want to know if this is true and, if so, how they can reduce their stress.”
Another important part is what can be dismantled in everyday life.
“In many Asian families, the concept of cancer is still stigmatized and we don’t talk about it,” Dr. Gomez said. “But as a result, we no longer recognize our own family history.”
Listen to Dr. Scarlett Lynn Gomez’s full conversation on Insights here.
