Black women more likely to skip crucial breast cancer treatments

September 20, 2018

A new study in the Journal of the National Cancer Institute finds that black women are more likely to skip hormone therapy treatments, also known as endocrine therapy, for breast cancer.

Endocrine therapy is used to add, block, or remove naturally occurring chemicals like estrogen and progesterone that stimulate some types of breast cancer. Evidence suggests that taking endocrine therapy for up to 10 years reduces the risk of breast cancer recurrence. However, between 15% and 49% of women with the disease never initiate endocrine therapy, and more than half do not take endocrine therapy drugs as recommended.

Nationally, breast cancer mortality is 41.5% higher among black women compared to white women, despite a historically lower incidence rate. Failure to receive appropriate treatment is an important cause of observed racial disparities in breast cancer mortality. Different use of endocrine therapy by race may contribute to breast cancer outcome disparities, but racial differences in treatment are poorly understood.

In this paper, researchers using data from the Carolina Breast Cancer Study investigated 1,280 women who reported being prescribed endocrine therapy; of these, 43% self-identified as black. For black women, overall, 24% reported underuse of endocrine therapy drugs, compared to 16% of white women. Compared to white women, black women more often reported not taking their pills every day as prescribed (14% versus 5%), whereas about 10% of both white and black women reported discontinuing their medication before the recommended time-period. Younger women were more often underusing endocrine therapy drugs, as were those women insured by Medicaid and those making less than $50,000/year.

A statistically significantly higher proportion of black women also reported: forgetting to take their drugs when traveling away from home (26% for black women versus 19% for white women); that sticking to their treatment plan was hard or very hard (27% versus 14%); trouble remembering to take their pills (27% versus 13%); missing pills due to cost (17% versus 7%); and severe side effects that led to skipping their endocrine therapy pills (25% versus 16%).

"This study provides evidence in a large, racially-diverse cohort study that black women with hormone receptor positive breast cancer experience unique barriers to endocrine therapy adherence which may lead to differential cancer outcomes by race, though we also found burdensome adherence barriers among white women," said lead author Stephanie B Wheeler. "These data are important because they shed light on the modifiable mechanisms through which multifaceted and culturally competent behavioral interventions can help women with breast cancer achieve the best outcomes."
-end-
The paper: "Endocrine therapy non-adherence and discontinuation in Black and White women," will be available to the public at https://doi.org/10.1093/jnci/djy136 on Sep 20 at midnight UTC.

Direct questions about the study to:

Stephanie B. Wheeler
Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill
135 Dauer Drive, CB#7411
Chapel Hill, NC 27516
stephanie_wheeler@unc.edu

To request a copy of the study, please contact:

Erin Brioso
Erin.Brioso@oup.com

Sharing on social media? Find Oxford Journals online at @OxfordJournals

Oxford University Press USA

Related Breast Cancer Articles from Brightsurf:

Oncotarget: IGF2 expression in breast cancer tumors and in breast cancer cells
The Oncotarget authors propose that methylation of DVDMR represents a novel epigenetic biomarker that determines the levels of IGF2 protein expression in breast cancer.

Breast cancer: AI predicts which pre-malignant breast lesions will progress to advanced cancer
New research at Case Western Reserve University in Cleveland, Ohio, could help better determine which patients diagnosed with the pre-malignant breast cancer commonly as stage 0 are likely to progress to invasive breast cancer and therefore might benefit from additional therapy over and above surgery alone.

Partial breast irradiation effective treatment option for low-risk breast cancer
Partial breast irradiation produces similar long-term survival rates and risk for recurrence compared with whole breast irradiation for many women with low-risk, early stage breast cancer, according to new clinical data from a national clinical trial involving researchers from The Ohio State University Comprehensive Cancer Center - Arthur G.

Breast screening linked to 60 per cent lower risk of breast cancer death in first 10 years
Women who take part in breast screening have a significantly greater benefit from treatments than those who are not screened, according to a study of more than 50,000 women.

More clues revealed in link between normal breast changes and invasive breast cancer
A research team, led by investigators from Georgetown Lombardi Comprehensive Cancer Center, details how a natural and dramatic process -- changes in mammary glands to accommodate breastfeeding -- uses a molecular process believed to contribute to survival of pre-malignant breast cells.

Breast tissue tumor suppressor PTEN: A potential Achilles heel for breast cancer cells
A highly collaborative team of researchers at the Medical University of South Carolina and Ohio State University report in Nature Communications that they have identified a novel pathway for connective tissue PTEN in breast cancer cell response to radiotherapy.

Computers equal radiologists in assessing breast density and associated breast cancer risk
Automated breast-density evaluation was just as accurate in predicting women's risk of breast cancer, found and not found by mammography, as subjective evaluation done by radiologists, in a study led by researchers at UC San Francisco and Mayo Clinic.

Blood test can effectively rule out breast cancer, regardless of breast density
A new study published in PLOS ONE demonstrates that Videssa® Breast, a multi-protein biomarker blood test for breast cancer, is unaffected by breast density and can reliably rule out breast cancer in women with both dense and non-dense breast tissue.

Study shows influence of surgeons on likelihood of removal of healthy breast after breast cancer dia
Attending surgeons can have a strong influence on whether a patient undergoes contralateral prophylactic mastectomy after a diagnosis of breast cancer, according to a study published by JAMA Surgery.

Young breast cancer patients undergoing breast conserving surgery see improved prognosis
A new analysis indicates that breast cancer prognoses have improved over time in young women treated with breast conserving surgery.

Read More: Breast Cancer News and Breast Cancer Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.