Racial/ethnic disparities in breast and gynecologic cancer treatment and outcomes

Abstract

To review recent research in racial/ethnic disparities in breast and gynecologic cancers, focusing on disparities occurring postdiagnosis. Mortality statistics show that of the cancers under study, breast cancer has the greatest impact, and of racial/ethnic groups, African Americans suffer the greatest disparities, with highest mortality rates for breast, uterine and cervical cancers, and second highest for ovarian cancer. Recent studies demonstrated that black breast cancer patients suffer more underuse of appropriate adjuvant therapy, and greater delays in diagnosis and institution of treatments, and blacks and Hispanics suffered greater postsurgical pain and symptomatology. Data indicate that the biology of some breast cancers in blacks is unique and more aggressive. One study demonstrated that more black breast cancer patients died of nonbreast cancer causes and that excessive comorbidity in blacks explained substantial amounts of survival disparity. Research is beginning to identify important disparities in nonblack minority racial/ethnic groups, including Hispanics and South Asian Americans. Research is continuing to identify and explain an important group of disparities - African American disparities in breast cancer outcomes. Disparities in other minority racial/ethnic groups, and in ovarian, uterine and cervical cancers, are at an emerging stage. Continuing efforts at all fronts are needed.