Recommendations for Breast Cancer Screening Do Not Account for Ethnic Differences
Take-Home Message:
There are differences in age distribution of breast cancer among ethnic groups. These differences make it unlikely that current breast cancer screening recommendations apply equally to every woman in the United States.
Race/Ethnicity and Age Distribution of Breast Cancer Diagnosis in the United States
Authors: Stapleton, S.M., Tawakalitu O. Oseni, et. al.
Source: JAMASurgery Research Letter published online 7 March 2018
jamanetwork.com/journals/jamasurgery/article-abstract/2673936
Recommendations for breast cancer screening have been updated within the past 10 years, and debates continue about them. The investigators point out that the recommendations were derived from studies and statistics of patients who were mostly white. They suspected that the experiences of breast cancer among nonwhite women in the US would lead to different breast cancer screening recommendations for these groups.
Using a national database, this study evaluated over 747,000 women diagnosed with breast cancer over a 37 year period. Seventy seven percent of the women were white; 9.3% were black; 7% were Latina and 6.2% were Asian. They found that the peak ages of breast cancer among white women were the 60s, while the peak ages among nonwhite women were the 40’s. Moreover, a higher percentage of nonwhite women present with advanced stages of breast cancer at the time of diagnosis.
For white women, the median age at breast cancer diagnosis was 59. The median age for black women was 56. It was 55 and 56 for Latina and Asian women, respectively. Looking within each age group for cases of breast cancer diagnosed younger than age 50, higher proportions of black, Latina and Asian women were affected (31%, 35%, 33%) than were white women (24%).
The researchers note that breast cancer screening programs for black and Asian women would have to start at age 47, and a screening program for Latinas would have to start at age 46 to show the same health benefits of a screening program that is recommended to start at age 50 for white women.
This study supports tailoring breast cancer screening recommendations depending upon a woman’s ethnicity. It also brings attention to the need for more diverse populations in scientific studies. Data that is collected from a largely homogeneous group cannot apply to a heterogeneous population.
