Harvard Health Letter Editors Examine Racial Disparities In Breast, Prostate Cancer

In Newsweek, Peter Wehrwein, editor, and Anthony Komaroff, editor-in-chief of the Harvard Health Letter, examine racial disparities in breast and prostate cancer outcomes. Black men in the U.S. have the highest prostate cancer rate in the world and are twice as likely as white men to die from the disease. Even though black women are less likely than whites to have breast cancer, they have a higher mortality rate from the disease.

According to the authors, researchers still do not know exactly why blacks are more likely than whites to die from the cancers. Young black women with breast cancer are more likely to have triple-negative tumors, which are particularly aggressive and cannot be treated with anti-estrogen drugs or anti-HER2 treatments. Researchers also know that young black women are disproportionately affected by basal-like carcinomas, which have an even worse prognosis than other types of triple-negative breast cancer. Some small-scale research indicates that black men might have androgen receptors that respond more intensely to testosterone, which could stimulate growth of prostate-cancer cells.

Differences in education, income and access to care might be more important in explaining the disparity than scientific findings, some researchers believe. For instance, black women generally experience a longer delay from the time of the discovery of a breast cancer abnormality and follow-up tests than white women, the authors write. In addition, black men are less likely than white men to receive aggressive prostate cancer treatment.

Various efforts are addressing barriers to screening diagnosis and treatment, and some researchers are optimistic about closing the gap, particularly with new knowledge of tumor biology leading to treatment improvements, the authors say. In addition, it is "significant" that the socioeconomic and biological issues behind the disparities are on the agenda at cancer research meetings, according to the authors.

Harold Burstein, a breast cancer specialist at the Dana-Farber Cancer Institute, said, "There is increasing awareness, and people are finally getting motivated to do something about it" (Wehrwein/Komaroff, Newsweek, 6/14).


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