Death For Black Women Research Articles

18F-Fluoroestradiol: Current Applications and Future Directions

In the United States, breast cancer is the second leading cause of cancer death in all women and the leading cause of cancer death in Black women. The breast cancer receptor profile, assessed with immunohistochemical staining of tissue samples, allows prediction of outcomes and direction of patient treatment. Approximately 80% of newly diagnosed breast cancers are hormone receptor (HR) positive, which is defined as estrogen receptor (ER) and/or progesterone receptor (PR) positive. Patients with ER-positive disease can be treated with therapies targeting the ER; however, the assessment of ER expression with immunohistochemical staining of biopsy specimens has several limitations including sampling error, false-negative results, challenging or inaccessible biopsy sites, and the inability to synchronously and serially assess all metastatic sites to identify spatial and/or temporal ER heterogeneity. In May 2020, after decades of research, the U.S. Food and Drug Administration approved the PET radiotracer fluorine 18 (18F) fluoroestradiol (FES) for clinical use in patients with ER-positive recurrent or metastatic breast cancer as an adjunct to biopsy. FES binds to the ER in the nucleus of ER-expressing cells, enabling whole-body in vivo assessment of ER expression. This article is focused on the approved uses of FES in the United States, including identification of a target lesion for confirmatory biopsy, in vivo assessment of biopsy-proven ER-positive disease, and evaluation of spatial and temporal ER heterogeneity. FES is an example of precision medicine that has been leveraged to optimize the care of patients with breast cancer. © RSNA, 2023 See the invited commentary by Fowler in this issue. Quiz questions for this article are available through the Online Learning Center.

Breast Cancer Top Cause of Cancer Death for Black Women

Breast Cancer Top Cause of Cancer Death for Black Women

Abstract PO-205: Association of pre-diagnostic cigarette smoking and alcohol consumption with mortality in Black breast cancer survivors

Abstract Purpose: There is limited data about how lifestyle factors are associated with breast cancer (BC) prognosis in Black women, as the majority of evidence is based on studies conducted in White women. Given the 40% increased risk of death for Black women diagnosed with BC compared to White women, and the differences in prevalence of these modifiable risk factors between racial groups, better understanding how these factors, among others, are associated with survival in Black women is necessary to address existing cancer health disparities. The purpose of this study is to examine the association of pre-diagnostic cigarette smoking and alcohol consumption with survival in a cohort of Black breast cancer survivors. Methods: We studied 1895 women enrolled in the Women's Circle of Health Follow-up Study, a population-based cohort study of Black BC survivors in New Jersey enrolled within 10 months of diagnosis. Smoking and alcohol consumption history, along with information on potential covariates were collected during in-person interviews. We evaluated the association between pre-diagnostic cigarette smoking (status, duration, intensity, pack-years) and alcohol consumption (average number of total drinks/week) and all-cause and BC- specific mortality using Cox Proportional Hazards models and Fine and Gray competing risk models, adjusted for confounders. Results: During 12,019 person years of follow-up (median 5.9, maximum: 14.8 years), we observed 290 deaths, of which 175 were breast-cancer related deaths. Currently smoking, particularly in regular drinkers, was associated with worse survival. Compared to never smokers, current smokers had 56% increased risk for all-cause mortality (hazard ratio (HR):1.56, 95% confidence interval (CI): 1.17-2.07), and this was higher for current smokers with pack years above the median (HR: 1.80, 95% 1.30-2.5). While the multiplicative interaction of smoking and alcohol was not statistically significant, compared to non-regular drinkers who never smoked, current smokers who regularly drank had a 72% increased risk of all-cause mortality (HR:1.72, 95% CI: 1.11-2.67), whereas the association for current smokers that were not regular drinkers was less substantial (HR: 1.41, 95% CI: 0.95-2.09). We observed similar associations for BC-specific mortality, with a 60% increased risk of BC-specific mortality (HR: 1.6, 95% CI: 0.92-2.78) for current smokers who regularly drank, but no association for current smokers who were not regular drinkers. We did not observe an association for smoking and BC-specific mortality or for alcohol consumption and all-cause or BC-specific mortality. However, self-reported alcohol drinking was low in this population (only 12% of women reported consuming >3 drinks/week). Conclusion: In a population based-study of Black BC survivors, smoking prior to a BC diagnosis was associated with worse overall survival, particularly in women who also regularly consumed alcohol. Citation Format: Nur Zeinomar, Saber Amin, Bo Qin, Yong Lin, Baichen Xu, Dhanya Chanumolu, Coral O Omene, Karen S Pawlish, Kitaw Demissie, Christine Ambrosone, Chi-Chen Hong, Elisa V Bandera. Association of pre-diagnostic cigarette smoking and alcohol consumption with mortality in Black breast cancer survivors [abstract]. In: Proceedings of the AACR Virtual Conference: 14th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2021 Oct 6-8. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr PO-205.

Analysis of the racial profile of women with COVID-19: a cross-sectional study about evolution to death of black women in the southeast region of Brazil

Introduction: The first coronavirus disease (COVID-19) case in Brazil was registered in December 2019. Since then, an important social situation has been highlighted. Black women correspond to the highest death rate, by group, in the Southeast even not occupying the highest percentage of diagnosis. This scenario was also experienced in other places around the world. Therefore, some questions must be highlighted, such as social and economic vulnerability of black population in brazilian territory, less access to health service and testing for Covid-19. Objective: This study analyzed the clinical picture and evolution - cure or death-of black women with COVID-19 in the Southeast region. In addition, consolidating knowledge about the factors that precede death in black women and comparing them with other race groups. Methods: Cross-sectional study with data from the Ministry of Health's Severe Acute Respiratory Syndrome (SARS) from March to November 23, 2020, with a total number of women classified as level 5, with SARS caused by the virus SARS-Cov-2, equal to 33,991, being 21,551 white and 12,063 black. Results and Conclusion: Therefore, black women present themselves as a vulnerable group in relation to COVID-19. This group was less present in the ICU, but both groups, white and black women, had dyspnea as an aggravating factor. Considering those facts, it's possible that black women had less access, this would explain a greater number of deaths among this group compared to white women, which could signify a failure in the health care of this population. When analyzing deaths by age group, it is evident that white women followed the literature pattern - severe forms occur in patients over 65 years of age with comorbidities, while there was a rejuvenation of deaths among black women. It is a limitation of our study not to include comorbidities in the analysis. This situation becomes relevant for directing public policies that aim to reverse the factors associated with this situation. More studies are needed to elucidate the socioeconomic issues that support this outcome, seeking to reduce the number of deaths from COVID-19 in black women.

Black Religious Studies, Misogynoir, and the Matter of Breonna Taylor’s Death

This article reflects on the matter of state-sanctioned death in Black religious studies, with the murder of Breonna Taylor as its central focus. It examines how scholars of Black religion engage with the issues of state-sanctioned murder, antiblackness, and misogynoir, and it endeavors to underscore ways for Black male* scholars of Black religion to respond to the religious experiences and deaths of Black women and Black people of all gendered experiences. This article’s central claim is that if Black male* scholars of Black religion continue to underscore how Black religion has been a catalyst for Black liberation without attention to how cisheteropatriarchy functions as antiblackness, then we ultimately will be unable to speak the name of Breonna Taylor in earnest.

The Rise of Black Feminist Intellectual Thought and Political Activism in Perinatal Quality Improvement: A Righteous Rage about Racism, Resistance, Resilience, and Rigor

AbstractIn this description of her work in perinatal quality improvement, obstetrician and crunk public health scholar Dr. Karen A. Scott describes the ways in which perinatal quality improvement has typically prioritized the deaths or near deaths of Black women at the exclusion of the lived experiences of Black women and people as patient, community, and content experts. Drawn into the work to apply a Black women‐centered and liberatory analytic, Dr. Scott turned to Black feminist anthropology to transform perinatal quality improvement ethics and theories of change. The work of Leith Mullings, particularly her excursus on the Sojourner Syndrome, was at the center of Dr. Scott's approach to abating Black perinatal death and redesigning perinatal quality improvement.

Pregnancy-related death disparities in non-Hispanic Black women.

While the rate of pregnancy-related death steadily increases in the United States, this tragic outcome is disproportionately devastating US-born non-Hispanic Black women at a rate that is three to four times that of their White and non-Black Hispanic counterparts. These disparities persist despite controlling for variables such as socioeconomic status, education levels, and geographical location. Pregnancy-related deaths in Black women are largely cardiovascular in etiology, and while these complications also occur in women of other ethnic backgrounds, they often are more severe and more deadly in Black women. This population often lacks adequate prenatal care likely because they face personal and structural barriers. Reversal of barriers during the prenatal period, the implementation of medical protocols during delivery, and the assurance of close follow-up during the postpartum year are vital in improving outcomes. This article will detail seven specific concerns within perinatal care and pregnancy-related death, and offer potential solutions to addressing them. Pregnancy-related death in Black women is not as an isolated event, but rather is one adverse outcome that exists on a broad spectrum of adverse outcomes. Now is the time to reckon with the reality that our nation’s Black women are dying at a disproportionate rate compared to women of other ethnicities due to pregnancy-related complications and suffering lifelong consequences even if they escape this fatal outcome. This is a call to action to understand this deeply devastating, multi-factorial issue so we may strive to eliminate this highly preventable and tragic event altogether.

Survival differences by race after minimally invasive versus open radical hysterectomy.

6029 Background: Black patients with cervical cancer have historically experienced worse survival compared with white women, as well as decreased rates of minimally invasive surgery (MIS) including radical hysterectomy. The goal of our study is to evaluate if this disparity in survival outcomes reverses in light of new findings favoring an open approach for patients with stage IA2 and IB1 cervical cancer compared to MIS. Methods: The National Cancer Database was queried, and all black and white women with stages IA2 and IB1 cervical cancer who underwent radical hysterectomy from 2010 to 2015 were included. Patients without survival data or documented surgical approach were excluded. Demographic factors were compared using student t-tests and Z-test of proportions as appropriate. Hazard ratios (HR) for the event of mortality were calculated by race and by route of surgery. Kaplan-Meier plots were created to compare survival between groups, and the Cox proportional hazards model was used to adjust for covariates. Results: 4915 patients were identified for inclusion, 12.1% black and 87.9% white. 43.0% of patients underwent open surgery (84.9% white and 15.1% black) and 57.0% underwent MIS (90.1% white and 9.9% black). Average follow up time between groups was 39.5 months for black patients and 40.6 months for white patients. Black patients who underwent open surgery had a hazard ratio (HR) for mortality of 1.44 (95% CI: 1.03-2.00), and those who underwent MIS had a HR of 1.48 (95% CI: 1.03-2.12), when compared to white patients. Mortality rates for black patients undergoing open radical hysterectomy remained higher than those for white patients who underwent MIS. When adjusted for age, insurance status, neighborhood income and educational level, tumor type, Hispanic ethnicity, node positivity and tumor size, these hazard ratios were no longer significant. Conclusions: Following discoveries of improved outcomes following abdominal radical hysterectomy as compared with MIS, we have identified that the discrepancy in ability to undergo MIS did not resolve previously identified disparities in the outcome of death for black women.

Insulin-like growth factor 2: a poor prognostic biomarker linked to racial disparity in women with uterine carcinosarcoma.

The objective of this study was to investigate the relationship of insulin‐like growth factor 2 (IGF2) expression and survival in women with uterine carcinosarcoma (UCS). Insulin‐like growth factor 2 protein expression was determined by immunohistochemical staining of tumor tissues from 103 patients with UCS. The H‐score (product of staining intensity and percentage positive cells) was quantified for the epithelial cytoplasmic (EC), epithelial nuclear (EN), and malignant stromal compartments. Multivariable Cox proportional hazard regression models were used to examine the relationship of IGF2 levels with progression‐free survival (PFS) and overall survival (OS). Adjusting for stage, race, and adjuvant therapy, PFS and OS were reduced in patients with high IGF2 (H‐score ≥ median) in the EC and EN compartments. Black race was independently associated with reduced PFS and OS in patients with early‐stage disease, and IGF2 levels in the EC were higher in black than in white patients (P = 0.02, Wilcoxon test). In a race‐stratified multivariable analysis, high IGF2 in the epithelial compartments more than doubled the risk of death in black women; HR = 2.43 (95% CI: 1.18–5.01, P = 0.02) for high IGF2 in the EC; and HR = 2.34 (95% CI: 1.25–4.39, P = 0.008) for high IGF2 in the EN. In conclusion, high tumor IGF2 expression is an independent risk factor for reduced PFS and OS in UCS. Black women have elevated tumor IGF2 compared with white women, and decreased survival associated with high IGF2. These findings identify IGF2 as a candidate biomarker for survival linked to racial disparity in women with UCS.

Stroke mortality in blacks. Disturbing trends.

Despite long-term declines in US stroke mortality rates, declines have slowed in the past decade and targets for blacks for the years 2000 and 2010 seem attainable only by extraordinary measures, if at all. This review focuses attention on key aspects of this problem. Data from the US National Center for Health Statistics and reports of population-based studies of stroke mortality published since 1987 retrieved by computerized literature searches were reviewed. The third leading cause of death in black women and the sixth in black men in the United States in 1996, stroke accounted for 10 509 deaths in women and 7972 in men among blacks: 7.92% and 5.33%, respectively, of the total deaths. Age-adjusted death rates per 100 000 were black women, 39.2; white women, 22.9; black men, 50.9; and white men, 26.3. Available data indicate that compared with US whites, US blacks have greater mortality rates for every stroke subtype, with the likely exception of cerebral infarction due to extracranial carotid artery occlusion. These differences will persist into the 21st century. The number of stroke deaths in blacks increased by >8% between 1992 and 1996. Increased research on stroke in blacks is needed to develop more effective strategies for primary and secondary prevention of stroke to reduce the high burden of premature mortality and morbidity. Renewed efforts to prevent and control stroke risk factors (in particular elevated blood pressure, diabetes, and smoking) are needed among US blacks.

Fetal Death in a Population of Black Women

To describe the clinical causes of fetal death in black women, we performed a record review of the primary causes of fetal deaths (n = 315, > or = 500 g or > or = 24 weeks' gestation) occurring over an 11-year period in a population of 26,852 black women who delivered at the Chicago Lying-in Hospital, University of Chicago Hospitals, Chicago, IL. The over-all fetal death rate (FDR) per 1,000 total births was 11.7, consistent with U.S. vital statistics data for blacks. The FDR per 10,000 births attributed to hypertension was nine times greater in our population than in a historical comparison population of Canadian white women: 19.5 (95% CI = 13.7, 25.4) versus 2.2 (P < .0001), respectively, although the prevalence of hypertension was only 1.2 times greater in the population of black women. Furthermore, hypertension in pregnancy accounted for 15% of the excess fetal mortality in our population of urban black women as compared to the population of Canadian white women. Health care providers should be aware of the risk of fetal death in hypertensive, innercity, U.S. black women.