The Increasing Disparity in Breast Cancer Mortality
A recent article in Cancer Epidemiology by Hunt et al has triggered renewed interest in developing a coordinated city response to persistent disparities in female breast cancer mortality between Blacks and Whites. The Boston Public Health Commission's Research and Evaluation Office conducted an independent analysis reviewing Boston data form a 12-year period and confirmed the findings of Hunt et al. Despite the targeted efforts to address the identified inequities in breast cancer mortality during the time-period reviewed between 2001-2012, the Commission's analysis found that there is an expanding breast cancer mortality gap between Black and White women in the City of Boston and that Black women are dying from breast cancer at a younger ages than White women.
The Boston Public Health Commission's Research and Evaluation Office's analysis yielded the following key findings:
- Mortality Disparity: The overall female breast cancer mortality in the City of Boston has decreased for all races/ethnicities. However, the decreases in mortality for white women are statistically
- Age-Adjusted Mortality: BPHC data reflects that between 2007-2012, Black women between the ages if 35-44 experienced a 166% higher mortality rate compared to White women of the same ages. Similarly, Black women between the ages of 45-54 experienced at 68% higher mortality rate than their White counterparts.
- Screening Rates: Black women ages 40+ in the City of Boston have a higher mammography screening rate than White women (88% vs. 83%, respectively)
- Excess Deaths: In calculating excess deaths from the expected and observed mortality of Black and White women in the City of Boston during the 12 year period reviewed, Black women experienced 74 excess deaths among women under the age of 65
Data on Breast Cancer Mortality in Boston
Black Women have the Highest Breast Cancer Mortality in Boston
Between 2001-2012 black women in Boston died due to breast cancer at a rate 25% higher than for white women. Black and white women had much higher mortality rates than Latina and Asian Boston residents. The Boston Breast Cancer Equity Coalition (BBCEC) aims to identify factors that contribute to this mortality gap and implement interventions to reduce it.
Disparities in Breast Cancer Mortality Rates in Boston are Increasing
Breast cancer mortality rates in Boston decreased between 2001 and 2012, with the greatest decrease occurring among Latina women. Though breast cancer mortality rates among Latina women remain relatively low, the rate for 2007-2012 was more than 2.5 times the rate for 2001-2006.
Mammography Screening Rates are Similar Between Racial Groups
Higher mortality among black female Boston residents does not appear to be driven by differences in obtaining mammography screening. According to data from the Boston Behavioral Risk Factor Survey, black and white women have very similar rates of mammography, and screening rates have been stable over time. While Asian women have the lowest breast cancer mortality rates in Boston, they also have the lowest rates of mammography. Because of data like this, the BBCEC will focus our efforts to reduce mortality disparities on factors after screening, like follow-up of abnormal mammograms, delays in treatment, and treatment quality.