When it comes to breast cancer deaths, place and race matter | St. Louis Public Radio

When it comes to breast cancer deaths, place and race matter

Jul 6, 2018

Credit Angie Wang | NPR

For breast cancer patients, race and geography can mean the difference between surviving and succumbing.

Washington University researchers have identified distinct hot spots in the U.S. where women are more likely to die from breast cancer. For African-American women and Latinas, these hot spots are predominantly clustered in specific regions across the southern U.S.

Breast cancer remains a leading cause of death for women in the U.S., accounting for over 41,000 deaths each year. Despite improvements in overall breast cancer survival rates over the last several decades, major racial differences in mortality rates have persisted.

“African-American women are 71 percent more likely to die from breast cancer within five years [of diagnosis] compared to white women,” said Justin Xavier Moore, a postdoctoral researcher at Washington University School of Medicine. “Hispanic women have a 14 percent increased risk of dying from breast cancer.”

Race alone may only tell part of the story, however.

A team of researchers, including Moore, have identified 80 counties in the U.S. with the highest breast cancer mortality rates. Within these counties, the overall mortality rate was 18 percent higher compared to other counties.

Breast cancer mortality hot spots, among all women in the contiguous United States, 2000-2015.
Credit Justin Xavier Moore | Washington University in St. Louis

Nine counties in Missouri had elevated rates of overall breast cancer mortality. They are Carroll, Chariton, Henry, Livingston, New Madrid, Osage, Saline, Scott and Stoddard Counties. There were no breast cancer hot spots in Illinois.

For black women in particular, national mortality hot spots were clustered in two regions: the southern Mississippi River valley and coastal North Carolina. In contrast, Latinas had the highest mortality rates in southern Florida and the southwestern United States.

“The southern Mississippi River is a hot spot area that has been persistently associated with poor health,” Moore said. “If you take a boat and get in the Mississippi River, every county that touches that river for the most part has an elevated risk of some disease. [It’s] a hot spot for lung cancer mortality, for sepsis, for coronary heart disease.”

Breast cancer mortality hot spots, among all non-Hispanic African-American women in the contiguous United States, 2000-2015.
Credit Justin Xavier Moore | Washington University in St. Louis

The team identified specific demographic characteristics in these areas that may help explain differences in mortality rates, including adult obesity, higher prevalence of smoking and a higher percentage of people who could not see see a doctor in the past year due to cost.

Lack of access to affordable medical care, particularly within marginalized communities, likely also contributes to racial differences in breast cancer mortality.

“Oftentimes, these women have less access to health care, therefore they’re presenting to their oncologist at a later stage disease,” said Moore. “If you’re presenting at stage 4 or stage 3 and it’s metastasized, then your chances of surviving to five years are already reduced in itself.”

The authors say the results can help highlight regions in need of targeted cancer prevention efforts.

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