Study Recommends Black Women Screen for Breast Cancer Sooner, Due to Earlier Mortality Risks
Michelle Milliken
Black women face a variety of disparities with regard to breast cancer, from a higher mortality rate, to higher rates of triple negative breast cancer, to more diagnoses at an early age. With similar findings on mortality, a new study from Germany finds that screening guidelines should call for earlier mammograms for Black women.
Researchers from the German Cancer Research Center and the National Center for Tumor Diseases in Heidelberg recently examined American breast cancer mortality rates by race to better form recommendations on early breast cancer detection. They found that Black women face an earlier risk of mortality, with this population facing the same breast cancer mortality risk at 42 as the average American woman does at 50. Asian and Pacific Islander women, meanwhile, don’t reach this same level until age 61. The researchers say these findings show the need to adjust screening recommendations by race.
Dr. Mahdi Fallah, study co-author and researcher at the German Cancer Research Center and NCT Heidelberg, explains, "Unfortunately, despite these enormous differences, no screening recommendations have been derived to date that are adjusted to the individual risks depending on the ethnic descent.”
To gauge mortality risks by race, the team analyzed National Center for Health Statistics data from more than 415,000 American women who died of breast cancer between 2011 and 2020. They found that in their 40s, Black women had a substantially higher breast cancer death rate, with 27 deaths per 100,000 person years, compared with 15 for white women and 11 for Asian or Pacific Islander women. The national average was 15.
With these figures, the researchers calculated the average risk of dying from breast cancer at different ages. For the average American woman at age 50, the mean 10-year cumulative risk of dying from breast cancer was 0.329%. Black women, however, reached that at age 42. White women did so at 51, and Asian and Pacific Islander women at 61.
The average overall risk percentage at 45 was also reached by Black women at the age of 38, while they reached the average risk of a 40-year-old at 34.
The recommendations for mammograms in the United States vary, with some saying women don’t need to begin regular mammograms until they’re 50. The researchers say it may be beneficial to adjust this based on race, due to the higher risks for Black women.
Fallah explains, “Screening according to a 'one size fits all' scheme disadvantages women from certain ethnic groups. Other women, on the other hand, may take up breast cancer screening unnecessarily early and thus may be more likely to experience their adverse side effects, such as false-positive tests or overdiagnosis. With the results of our studies, we can now make evidence-based recommendations for starting breast cancer screening that are adjusted for ethnic ancestry.”
To read the whole study, published in JAMA Network Open, click here.
