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| Photo credit – University of Georgetown Media Department |
CANCER DIGEST – Oct. 23, 2021 – A new statistical model based on existing data and self-reported race demographics shows that if black women begin mammography screening every other year at age 40, the number of breast cancer deaths among black women could be reduced by 57 percent compared to starting such screening at age 50.
The report by researchers at Georgetown University Lombardi Comprehensive Cancer Center and the University of Michigan published their findings in the Oct. 19, 2021 Annals of Internal Medicine. Led by Dr. Christina Hunter Chapman in the Department of Radiation Oncology at the University of Michigan the investigators aimed to address the disparity of breast cancer in black women as compared to white women.
“There is an increasing focus on eliminating race-based medicine,” Hunter Chapman said in a press release. “However, calls to end race-based medicine that ask for the immediate cessation of any discussion on race are not likely to eliminate racial disparities. Carefully selected solutions for health inequity may involve tailoring interventions to specific racial groups.”
The model used by the researchers included self-reported race as a proxy for who is likely to experience the effects of racism to test a range of screening strategies. They also included data about breast density, distribution of cancer subtypes, age, state and subtype treatment effects in their model.
“Black women have higher rates of aggressive cancers at younger ages than white women, and treatments for those types of tumors are not as effective," Jeanne S. Mandelblatt, MD, MPH the study’s senior author said in a press release. "However, even when we account for cancer subtypes, mortality is higher for black women largely due to factors that are ultimately rooted in racism.”
In addition to all this data, the model compared the benefits and harms of different screening strategies in Black women to those for white women screened according to current guidelines set by the US Preventive Services Task Force. Those guidelines call for mammography screening every other year starting at age 50.
The researchers used their model to project lifetime impact of digital mammography starting at three different ages, 40, 45 and 50. The model compared a variety of benefits including number of years of life gained by detecting cancer early, breast cancer deaths averted and mortality reduction to harms of undergoing more mammograms and the potential for more false-positive results.
The modeling showed that starting screening at age 40 yielded the greatest benefit compared to potential harms and resulted in reducing cancer deaths among black women by 57 percent.
“In the future, the harms of racism in medicine may be better rectified by developing interventions that use more direct measures of racism instead of race,” Chapman concluded.
Sources: University of Georgetown press release and the Annals of Internal Medicine
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