A study released Tuesday by the Sinai Urban Health Institute reveals that black women in Chicago are dying of breast cancer at a higher rate than white women.
Released during a press conference held downtown at the Hyatt Regency Hotel, the study showed that in 2003, black women in Chicago were 75 percent more likely to die as a result of breast cancer. Nationwide, the mortality rate discrepancy between black and white women was 37 percent. The gap has increased since 1980, when mortality rates were almost equal.
The study also found that the death rate among black women is growing because black women are not recieving the proper screenings and care.
“The most disheartening thing about the findings of the study is that in the last 22 years of medical breakthroughs, and advancement in mammography technology, that black women have not gained or benefited from that progress,” said Alan Channing, president and CEO of Sinai Health System, on Tuesday.
Among the study’s other findings:
In 2003, per 100,000 women, of every 26 white women that die from the effects of breast cancer annually, 40 black women die in the city of Chicago. A disparity difference of 75 percent
In 2002, per 100,000 women, for every 126 black women that get breast cancer, there are 149 white women who get breast cancer, however, black women die at a rate of more than 40 percent as opposed to only 26 percent for white women.
By 1998, the disparity gap began to widen until, by turn of the century, black women died nearly a third more often.
In 2003, black women had a mortality rate about 37 percent higher than white women.
Black women in Chicago are far more likely to be diagnosed in the late stage of the disease; the early cancer detection rate for black women is still only 69 percent of the rate of white women.
“There is no evidence of any biological difference between black and white women, so we concluded that the disparity could be traced back to three primary causes,” said Dr. Steven Whitman, director of the Sinai Urban Health Institute. “One, African-American women may be receiving fewer mammograms in general, and in a less than optimal sequence. Two, mammography screenings received by African-American women may be of lesser quality [and] three, African-American women may receive delayed or less effective treatment once breast cancer is diagnosed.”
Whitman added that in dealing with these three issues, the solution as agreed upon by he and his partners would entail first forming a city-wide task force to investigate the matter.
Comprised of health providers and leaders, the task force would hold a summit in February 2007 on the disparities, inviting all area health institutions to participate and discuss solutions.
The task force will issue a written report by December 31, of next year, outlining the actions that participating health care institutions are taking to eliminate the disparities.
The task force will be led by Ruth Rothstein, president of the Board of Directors at Rosalind Franklin University of Medicine and Science; Sheila Lyne, CEO of Mercy Hospital and Medical Center; and Donna Thompson, CEO of Access Community Health Network.
“The fact that we have not lowered the rate of mortality amongst African-American women in 20 years is appalling,” said Dr. Paula M. Grabler, former director of the breast health program for Mercy Hospital. “Every hospital should be required and monitored to assure that they adhere to the federal guidelines to assure that their mammography program is really serving the needs of the women it serves.”
Among those screening guidelines as outlined by the American College of Radiology (ACR) are:
Number of patients recalled from initial mammogram for additional screening should be between 5-10 percent, and not lower.
Number of patients with suspicious findings and/or biopsy with malignant findings should be between 25-40 percent.
Number of minimal cancers detected by mammograms should be at least 30 percent.
Number of cancers detected in earliest stages should be at least 50 percent.
Cancer detection rate per 1000 women screened should be between 2-10 women.
The report calls for Chicago hospitals and mammography centers, irregardless of area or location, to collect and share mammography quality measures as recommended by the ACR as the first step toward improving services.
“We need to assure that all health providers have the necessary equipment in all their clinics and hospitals capable of detecting breast cancer early,” said Dr. Pam Khosla, chief of Hematology and Oncology at Mount Sinai Hospital. “That means radiologist have the proper functioning mammography machines, and that they are able to contact the women once the results of their tests are gathered. We must make this a top priority in the next two years. The women deserve it.”
Despite these sobering findings regarding breast cancer within the black female population, all women ages 40 and over are still encouraged to have a mammogram every year, health experts say, and women in their 20s and 30s should have a clinical breast examiniation, or CBE as part of a regular exam by a health expert, preferably every three years. A CBE should be done annually after age 40, and women should see their doctor if they have any of the following symptoms: a lump or swelling, skin irritation or dimpling, nipple pain or the nipple turning inward, redness or scaliness of the nipple or breast skin, or a discharge other than breast milk.
The Sinai Urban Health Institutes’s study was funded in part by the AVON Foundation Breast Cancer Crusade, which donates $40 million annually in grants in support of breast cancer programs. For more information, visit the Sinai Urban Health Institute at www.sinai.org/urban/index.asp
