Raising Awareness to Improve Outcomes
- Actress Meagan Good, 44, began championing gynecologic health after a uterine cancer scare, urging Black women to talk openly about symptoms and screening.
- Research in Cancer Epidemiology, Biomarkers & Prevention projects a sharp rise in endometrial cancer over the next 30 years, with Black women facing nearly triple the mortality rate by 2050.
- Black women experience the highest mortality from both breast and uterine cancers, according to the American Cancer Society (ACS). They are 37% more likely to die from breast cancer than White women, despite being diagnosed less often, and survival is lower across nearly every cancer type, even when stage and socioeconomic status are the same.
- Systemic inequities drive much of the survival gap, with Black women up to twice as likely to miss guideline‑recommended cancer screenings for uterine and breast cancers, leading to later‑stage diagnoses.
- Data from Cancer Control show they are also less likely to receive minimally invasive surgery or timely hysterectomies and face higher recurrence rates.
“Gynecologic health is an important conversation to have at any age, but it’s not often discussed, especially in the Black community,” Good told Eisai, a pharmaceutical company focused on oncology research.
Black Women Face Higher Mortality From Breast Cancer
They are 37% more likely to die from breast cancer than White women, despite being diagnosed less often.
American Cancer Society
“I’m not afraid to have honest conversations with my friends, family, and doctor about gynecologic health, and I want to encourage everyone—particularly the Black community—to do the same so more people can identify potential signs of endometrial cancer early.”
Additional research published in Cancer Control shows that Black women are less likely to receive guideline‑concordant treatment, minimally invasive surgery, or timely hysterectomies, and they face higher recurrence rates after treatment.
WATCH: Addressing Disparities in Healthcare
The pattern extends beyond uterine cancer. According to the American Cancer Society (ACS):
- Black women have the highest mortality from both breast and uterine cancers, with uterine cancer deaths roughly twice those of all other women.
- Black women are 37% more likely to die from breast cancer than White women, despite being diagnosed less often—a gap that has barely shifted in nearly 20 years.
- Cancer survival is lower for Black patients across nearly every cancer type, even when stage at diagnosis and socioeconomic status are the same.
The ACS notes that Black patients are more likely to present with more aggressive disease, but the biggest driver of the survival gap is reduced access to high‑quality care—from prevention and screening to diagnosis and treatment.
Black women are also up to twice as likely as White women to miss guideline‑recommended diagnostic evaluation for uterine and breast cancers, leading to later‑stage diagnoses.
Only 56% of uterine cancers and 58% of breast cancers in Black women are caught early, compared to 71% and 69% in White women.
Good recently earned an “Impact” award for her continued efforts to improve the lives of others.
Ongoing Research to Better Understand the Disparities and Reverse Course
The SISTER study is the first randomized clinical trial in the U.S. designed specifically to improve outcomes for Black and African American women with endometrial cancer.
“No Black woman who faces this diagnosis should do so alone. This study shows that 1:1 peer support is medicine too,” says Dr. Kemi Doll, a gynecologic oncologist, surgeon, and health equity scientist at Fred Hutchinson Cancer Center at UW Medical Center.
Dr. Doll is also the founder of the GRACE (Gynecologic Research and Cancer Equity) Center.
Dr. Doll studied how different forms of social support influence treatment completion and recurrence among Black women with high‑risk endometrial cancer.
One of the most striking findings from the trial was that one‑to‑one peer support had a measurable, statistically significant impact on treatment completion.
84% of women who received individualized peer support completed their full treatment course, compared to roughly 50% of women who had no peer support at all.
Group‑based support showed smaller differences, with 68% of participants completing treatment compared to 64% without group support.
Doll noted patients who did not complete treatment mostly stemmed from disease progression, meaning the cancer worsened, or adverse side effects were too taxing on the body.
“Often, Black women are tasked with being strong and independent, but that kind of ‘strength’ is literally life-threatening when facing cancer treatment. This study was designed because earlier research found that Black women systematically were receiving less treatment and stopping earlier – factors directly related to our 2-fold increased mortality risk after endometrial cancer diagnosis,” Dr. Doll said.
The data reinforce what many clinicians and survivors have long described anecdotally, the “power of support” during cancer treatment.
In this case, the evidence shows that a personalized, one‑to‑one connection may be especially meaningful for Black women facing high‑risk endometrial cancer, offering a notable boost in treatment adherence and potentially improving long‑term outcomes.
Voice of Black Women
Another study, “Voices of Black Women,” aims to improve the health of Black women. It’s begun enrolling Black women between 25 and 55 from various U.S. states with sizeable Black or African American populations, including the Southeast, Mid-Atlantic, Midwest, and California.
The study follows women for 30 years to monitor their health.
“This study includes women who are not only African-American but may be of Caribbean or direct African descent who recently immigrated. We may find different patterns in these subgroups, which may be quite interesting. We haven’t had studies large enough to see if this population has distinct differences,” Dr. Kathie-Ann Joseph, a breast surgeon and vice chair for diversity and health equity in the Department of Surgery at NYU Langone Health Perlmutter Cancer Center, tells SurvivorNet.
While Black men and women experience higher mortality rates from cancer, women are the focus of the study.
Resources on Continued Efforts to Address Gaps In Cancer Care
- Black Women Die From Breast Cancer at Shockingly Higher Rates Than White Women
- Black Women May Need To Start Breast Cancer Screening At 42, According To A New Study
- Black Women With Breast Cancer Are Often Diagnosed Later & Have Lower Survival Rates: These Are a Few Reasons Why
- New Research Finds That Deaths From Uterine Cancer Among Black Women Are On the Rise in the U.S.: How to Close the Cancer Care Gap
- It’s Imperative Black Cancer Patients Get Better Access to Clinical Trials
Black Women and Breast Cancer
Dr. Joseph specializes in Black women’s cancer care, specifically breast and cervical cancer. She says the reason why the mortality rate for Black women diagnosed with these types of cancer is higher is complicated.
“Breast cancer tends to present at a younger age in Black women (median age of 58 versus 62), and Black women have a higher incidence of breast cancer in women under 40,” Dr. Joseph explains.
Women diagnosed with early-onset cancer (50 and younger) are “already an independent risk factor for higher mortality,” Dr. Joseph adds.
“Breast cancer-specific survival appears to be modulated by molecular subtype with larger differences in mortality rates observed among young women with hormone receptor-positive tumors,” Dr. Joseph said.
Women of African ancestry are more likely to get triple-negative breast cancer – an aggressive form of the disease – than women of other races and ethnicities.
RELATED: Clinical Trials for Breast Cancer
WATCH: Understanding triple-negative breast cancer.
Genes likely factor into who gets triple-negative breast cancer. Researchers at Weill Cornell Medicine found people whose breast tumors have higher levels of an immune-related gene called DARC/ACKR1 live longer after their breast cancer diagnosis. The gene, when present in breast tumors, slows the cancer’s growth and spread.
However, a gene mutation extremely common in women of sub-Saharan West African ancestry seems to lead to lower levels of DARC/ACKR1 in tumor tissue, which allows the tumors to grow and spread quickly. Women of African ancestry who have this gene mutation are at greater risk for triple-negative breast cancer.
One cannot ignore other factors such as access to care, cancer screenings, and healthcare provider bias.
“Access to screening as well as provider bias, both explicit and implicit in screening recommendations, and the treatment of Black women when diagnosed with breast cancer,” may also contribute to the higher mortality rate for Black women diagnosed with breast and cervical cancer, Dr. Joseph said.
SurvivorNet’s Close the Gap initiative is committed to drawing added awareness of these disparities and providing solutions to improve the survival rates of all people diagnosed with cancer, regardless of their background. Our partners in this initiative include NYU Langone and The Perlmutter Cancer Center. We are committed to the fight for equality.
Solutions to Closing the Gap
SurvivorNet experts recommend emphasizing earlier, more frequent screenings. Other focus areas to improve access to care for racially diverse groups include:
- Reviewing a patient’s family medical history
- Address income inequality. Lack of access to healthcare due to no or limited health insurance is a barrier for some low-income patients.
- Increased access to clinical trials and oncologists
- Greater overall access to healthcare
- Improve the number of oncologists from diverse backgrounds
Overcoming Cultural Barriers to Improve Healthcare for Black Women
Clinical trials and medical studies are crucial to understanding how medicine works. However, most people participating in these studies and clinical trials are white.
The American Society of Clinical Oncology (ASCO) says Black Americans are “under-represented in cancer clinical trials,” which can limit our understanding of therapeutic response to Black populations.
The Federal Drug Administration (FDA) said in a 2020 report that studied demographic data on clinical trials for drug participation, 75% of participants were white, 8% were Black African Americans, 6% were Asian, and 11% were Hispanic.
WATCH: Black Americans and cancer screenings.
The federal agency noted that patient recruitment and retention were critical to understanding the effectiveness of clinical trial results.
“As it is, patient recruitment in oncology clinical trials is quite low. For Black patients, it is about 4%,” Dr. Joseph said, regarding the need for more diverse participation in this critical area of medicine.
Dr. Joseph highlighted some key areas the healthcare community must address to improve Black and other racial groups’ participation in medical studies and clinical trials.
“Trust has to be built not only between the doctor and the patient but also between the hospital and the community.”
“Moreover, there should be efforts to recruit minority patients by having diverse staff and ensuring that the language used in the recruitment literature is at the appropriate reading level and translated into the languages common in the community,” Dr. Joseph explained.
Building Trust
“It all comes down to trust and familiarity,” psychologist and founder of InnoPsych, Dr. Charmain Jackman, tells SurvivorNet.
“Our shared heritage engenders trust and serves as a first step to Black people trusting the medical field. However, there is still so much inherent bias in the way we are trained that if the Black professional is not doing the work of decolonizing (i.e., removing bias) their practice, my guess is that trust will be hard to keep, and the Black patient may not return for care,” Dr. Jackman adds.
Efforts to get more Black Americans to heed medical information, even from legitimate sources, become easier once past racism in medicine is fully atoned.
WATCH: Merck’s Josette Gbemudu explains how to improve outcomes for Black cancer patients.
Among the most notable instances of racism in medicine are the 1932 U.S. Public Health Service (USPHS) Syphilis Study at Tuskegee. It involved 600 Black men, 399 with syphilis and 201 without the disease.
The men involved were not offered penicillin to treat the disease. An advisory panel sanctioned by the Assistant Secretary for Health and Scientific Affairs found the Syphilis Study was “ethically unjustified.”
Other cases that left Black Americans harmed in medical advancements include Henrietta Lacks, who sought medical treatment for what turned out to be a malignant tumor on her cervix.
According to Johns Hopkins Medicine, Lacks’ cells obtained during a biopsy functioned differently from normal cells.
Her cells, also known as “HeLa cells, doubled every 20 to 24 hours, while cells collected from others would die. Her cells have since been used to study the “effects of toxins, drugs, hormones, and viruses on the growth of cancer cells without experimenting on humans.” Problems arose once word spread.
Physicians kept Lacks’ family unaware that her cells were being used without consent.
Medical experiments by the “Father of Gynecology,” James Marion Sims, the 19th-century physician who developed techniques still used today in women’s reproductive health, add to the distrust.
Despite Sims’ development of long-lasting techniques, he did so at the expense of enslaved Black women.
The prices Black Americans paid because of these historical incidents are wide-ranging and still felt today. The distrust discourages Black Americans from engaging in clinical trials and medical studies in more significant numbers.
By not participating in clinical trials that test the effectiveness of new medical treatments, there is a lack of information on whether outcomes will be the same for these patients.
The Voices of Black Women study is the largest of its kind. With intentional efforts to target a diverse group of Black women who can connect with them culturally, we may get answers in the coming years about why this resilient group is at higher risk of dying from cancer.
Finding Resources And Support
For patients and families navigating cancer or another serious illness like a cancer diagnosis, gaining access to new treatment or trials can feel overwhelming. That’s why SurvivorNet encourages patients to use its proprietary Clinical Trial Finder, a free tool designed to help patients identify relevant trials quickly and easily.
Every year, new early-phase studies come online, each one representing another step forward in disease management.
SurvivorNet’s AI-powered “My Health Questions” tool was also built with patient needs in mind, to give patients and their caregivers access to health information vetted by professionals right when they need it.
Learn more about SurvivorNet's rigorous medical review process.
