"In the largest cities in the U.S., death rates from breast cancer have dropped across the board over 20 years, but far less so for black women than whites, according to a new analysis.
The widening survival gap is likely due to differences in the quality of healthcare and access to it, researchers contend, because health factors alone cannot explain the changes over two decades.
"The advancements in screening tools and treatment which occurred in the 1990's were largely available to White women, while Black women, who were more likely to be uninsured, did not gain equal access to these life-saving technologies," lead author Bijou Hunt, an epidemiologist at Mount Sinai Hospital in Chicago, told Reuters Health in an email.
Past research has examined racial differences in survival for specific cancers and for cancer in general and found at least some could be explained by biology. High blood pressure, diabetes and other health problems that both worsen cancer outcomes and are more common among blacks have received some of the blame.
Black women are also more likely than whites to have aggressive breast tumors that don't respond to the most effective treatments. This basic difference in cancer genetics is another reason given for differing survival when it comes to breast cancer.
To assess changes in survival trends on a national level, Hunt and her colleagues looked at mortality rates in the largest U.S. cities at four different time points: 1990-1994, 1995-1999, 2000-2004 and 2005-2009.
They found that during the 20-year span, deaths from breast cancer fell overall - by 13 percent for black women and by 27 percent for white women. While a gap was already present in the early 1990s, it widened considerably with time."