Let's 'Close the Gap' for Black History Month
- Black Americans continue to face the highest cancer mortality rates, driven by disproportionate burdens in prostate, breast, and uterine cancers.
- Limited access to high‑quality care, along with unconscious bias and treatment inequities, remains a major driver of survival gaps across nearly every cancer type.
- Closing these disparities requires collective action across the cancer community to expand prevention, screening, treatment access, and clinical trial participation for underserved communities.
The ACS reports that Black men face the highest prostate cancer death rates of any group, two to four times higher than other men. Black women experience the highest mortality from both breast and uterine cancers, with uterine cancer deaths roughly twice those of all other women.
Read MoreThe ACS notes that unconscious bias, treatment inequities, and limited access to high-quality care drive much of this divide. Even when stage at diagnosis and socioeconomic status are the same, Black patients have lower survival rates across nearly every cancer type. The biggest factor is unequal access to preventive care, receiving a timely diagnosis, and receiving effective treatment.
Addressing these disparities requires collective responsibility. The cancer community must work together to dismantle the systemic barriers that keep minority communities from receiving quality care, participating in preventive screenings, and enrolling in clinical trials.
Black Women and Mammograms & Preventive Mastectomies
The Centers for Disease Control and Prevention (CDC) analyzed data from the 2022 Behavioral Risk Factor Surveillance System to assess mammography rates among women aged 40 to 74 over the previous two years. The findings underscore the critical role of socioeconomic status and healthcare access in determining whether women receive regular screenings.
Women with reliable health insurance and quality medical care were significantly more likely to undergo mammograms, ensuring early detection and better health outcomes. In contrast, those facing systemic barriers—such as financial hardship, limited healthcare access, and social isolation—had lower screening rates, increasing their risk of undiagnosed breast cancer.
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The study identified several adverse social determinants of health linked to decreased mammogram use, including unemployment or underemployment, reliance on food assistance programs, lack of transportation, inadequate health insurance, low income, loneliness, and overall dissatisfaction with life. Addressing these disparities is crucial to ensuring all women—regardless of socioeconomic status—have access to vital preventative healthcare.
The report also pointed out that low-income Black women were more likely to die from breast cancer.
WATCH: Mammograms are still the best tool for detecting breast cancer.
Research published in the peer-reviewed Journal of the American College of Surgeons highlights a significant racial disparity in preventative mastectomies—procedures that can dramatically lower the risk of breast cancer for high-risk women.
“Black women with cancer in one breast are less likely than white women to undergo contralateral prophylactic mastectomies (CPM), a procedure to remove the unaffected breast,” researchers from the University of California, Los Angeles (UCLA) explained to UCLA Health.
The study, which spanned from 2004 to 2020, analyzed data from more than 597,000 women, including nearly 71,000 Black women. Findings revealed that, overall, Black women were 35% less likely to opt for preventative mastectomies compared to white women. Even at predominantly Black-serving hospitals, the likelihood of Black women receiving this procedure was 17% lower.
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“Our findings that Black-serving hospitals are less likely to perform CPM suggest these racial disparities are encoded structurally. We need to examine the systems-level factors affecting the care of Black women and address the deeper causes of structural racism to ultimately lead to equitable outcomes for all patients,” said Amulya Vadlakonda, the study’s lead author at the David Geffen School of Medicine.
These findings underscore the need to address healthcare inequities and ensure Black women receive the same access to preventative care that can be life-saving. Let me know if you’d like additional refinements!
Linda Tantawi was previously the chief executive officer of Susan G. Komen, New York City’s affiliate. While with the Komen organization, she enforced this sobering statistic, while Black women and white women are diagnosed with breast cancer at the same rate, Black women are 40% more likely to die.
“That is unacceptable,” she previously told SurvivorNet.
“Disparities in access to care are prevalent throughout the United States and increase women’s risk of dying from breast cancer,” she added.
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Prostate Cancer’s Effect on Black Men
“Prostate cancer affects men of all walks of life, but it affects them differently,” says Dr. Edwin Posadas, Director of Translational Oncology and the Medical Director of the Urologic Oncology Program at Cedars-Sinai. For example, the incidence of prostate cancer in African-American men is 60 percent higher, and they are two to three times more likely to die from the disease.
Since Black men tend to be diagnosed with prostate cancer at younger ages compared to other racial groups, the new guidelines state Black men should consider screening at 40 years old since this demographic group is regarded as a “high-risk population.”
“Few guidelines have outlined specific recommendations for prostate-specific antigen (PSA)-based prostate cancer screening among Black men,” researchers for PCF said in its report published in the Journal of Clinical Oncology.
“Discussions with health care providers about baseline PSA testing should begin by the time Black men are in their early 40s, and modeling data suggest prostate cancer develops 3-9 years earlier in Black men compared to their peers. Lowering the age for baseline PSA testing from 50-55 years to 40-45, followed by regular screening intervals until the age of 70, would reduce prostate cancer mortality in Black men,” the PCF said in its report.
RELATED: Black Men May Be More Susceptible To Advanced Cancer Due to Biomarkers in the DNA, Study Says
Why do Black and Other Communities of Color Participate in Clinical Trials Less?
Pew Research surveyed diverse Americans in 2021 on their views of clinical trials. It found that 59% of Black Americans and 58% of Hispanic/Latin American adults considered clinical trials “very important.” Black and Hispanic participants claimed that a desire to help others was among the leading reasons to support clinical trials.
However, they also worried about potential health risks that clinical trials presented, most notably using treatments that the U.S. Food and Drug Administration had not yet approved. There also existed a contingent of people expressing great skepticism of clinical trials by citing historical racial mistreatment of Black and brown people, such as the Tuskegee Syphilis Study.
WATCH: Clinical trials can be life-saving.
“Minority participation in clinical trials is necessary to create equality and eliminate disparities in the field,” researchers Dr. Karen Allison, a clinical instructor of ophthalmology at Mount Sinai Hospital, Deepkumar Patel at New York Medical College, and Ramandeep Kaur at New York Medical College, School of Health Science and Practice, said in their study published in Cureus.
Some health practitioners identified ways to improve Black participation in clinical trials. Some recommendations by the Association of American Medical Colleges (AAMC) include going into communities where mostly Black people live for recruitment.
Another method to help address the lack of trust among some Black community members in the healthcare industry is to acquire knowledgeable Black and brown people to do the outreach who can better communicate effectively with the community they are trying to reach.
Closing the Gap for Black History Month
One way to close the gap beyond Black History Month is to enroll more Black Americans in clinical trials. This will help researchers to learn more about risk-related genes common in people of African descent.
Unfortunately, hospitals that run clinical trials may do a poor job of enrolling a diverse mix of people, and Black people may be less likely to agree to participate. This is especially true for Black women when it comes to breast cancer.
Dr. Oluchi Oke, a breast medical oncologist at MD Anderson Cancer Center, previously told SurvivorNet that this is partially due to the deep mistrust in medical research.
"Part of that has to do with a long history of mistrust of clinical trials in the African American community based on a history of unethical clinical trials that were conducted in African American people,” Oke said. “And they don’t necessarily have updated information about the stringent protocols that clinical trials now must follow in order to be ethical.”
Conversely, doctors may be less likely to ask Black patients to join clinical trials because they assume the answer will be no.
“Don’t wait for your doctor to offer you a clinical trial. Ask,” Dr. Oke said.
Kimberly Alexander, chief executive officer at Level Health Agency, said during SurvivorNet’s Close the Gap conference last year that there also needs to be a continued commitment to representation in clinical trials.
“It can’t be, ‘Hey, we’re going to show up and support you all,’ five people turn out, and they decide they don’t want to come out and support anymore because they didn’t get the ROI (return on investment) they were looking for,” she said. “I think that there just needs to be some long-term ideas, some forward-thinking, some commitment to sticking with these communities and letting them know the importance of having their DNA in clinical trials.”
She highlighted the statistic that multiple myeloma is more likely to affect Black men than anyone, but “they’re not a part of the conversation because they’re not participating.” She added that there needs to be education and commitment from everyone involved in order to make a difference when it comes to the representation of Black people in clinical trials.
There is still a gap in knowledge for certain subpopulations depending on your genetic ancestry, and we are still trying to work that out," Melissa B. Davis, Ph.D., scientific director of the International Center for the Study of Breast Cancer Subtypes at Weill Cornell Medical College, previously told SurvivorNet.
“What we are working on is trying to increase the representation of non-European people in genetic studies so we can learn what these genes mean.”
Contributing: Sonya Collins & SurvivorNet staff reports
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