Those factors — along with poverty, lack of insurance and the aggressiveness of the cancer — seemed to explain much of the death-rate disparity between Black women and white women, the study found.
The racial gap in U.S. breast cancer death rates has long been recognized, and there have been efforts to address it. Those efforts can partly explain the improvement over time, according to Dr. Ahmedin Jemal, a senior vice president at the American Cancer Society, in Atlanta.
“For example, the National Breast and Cervical Cancer Early Detection Program, supported by the Centers for Disease Prevention and Control, contributed to an increase in mammography use in Black women,” says Jemal, who studies cancer disparities.
And in 2000, he adds, Congress passed a law to ensure that low-income women diagnosed through that program could receive treatment through their state Medicaid program.
But, Jemal says, lack of insurance remains a barrier for Black women.
“The gap still remains largely because Black women are more likely to be uninsured and underinsured,” he says. “They are less likely to receive timely and standard of care compared to white women.”
And while Medicaid coverage exists, programs vary from state to state in who qualifies and what is covered. So obstacles accessing Medicaid could also be an ongoing factor, according to Jemal.
The findings — published July 1 in the journal Cancer Epidemiology, Biomarkers & Prevention — are based on more than 250,000 Florida women diagnosed with breast cancer between 1990 and 2015.