Introduction
Breast cancer cases have shown an increasing trend over the last few decades. It is a disease that is common to women. However, some men have developed breast cancer but the rates of incidence of the disease are very low compared with that exhibited in women. In the US, breast cancer has been one of the fatal diseases that have affected a significant proportion of the female population. Breast cancer affect women from all races, ethnic groups, ages, geographic locales as well as socioeconomic strata.
Over the past several decades, epidemiological research has shown that there have been widespread ethnic disparities as far as the disease is concerned. It has been well documented that different ethnic groups have different rates of the incidence of breast cancer. This paper explores the different rates of breast cancer incidence as far as the different ethnic groups in the US are concerned as well as the most probable way of reducing the rates of incidence across all the groups.
The Incidence of breast cancer among different ethnic groups
One of the tools used in monitoring the incidence of breast cancer in the United States is the ‘report card’. The card was developed by key bodies in the American health care system. They include the American Cancer Society, National Center for Health Statistics, the National Cancer Institute and the Center for Disease Control and Prevention.
The initial release of the ‘report card’ was in 1998. It showed that there had been a continual decline in the incidence of breast cancer in the American population. However, the report card also showed that there was disproportionate incidence of breast cancer as well as mortality rates of African American Women compared with their white counterparts.
The report noted that among the African women, there was an increasing trend of both the incidence of breast cancer and the mortality rates associated with the disease. According to the report, “African American women also tended to present with a later stage at diagnosis” (Jones, and Chilton 341). The African American women have not been successful in their fight against breast cancer since study has shown that they have the highest breast cancer death rates.
From 2000-2003, the white non-Hispanic Americans recorded the highest rates of breast cancer incidence i.e. 141 women in every 100,000 had developed cancer. The second highest rate was exhibited by the African Americans with 118 breast cancer patients per every 100, 000.
The third and fourth positions were taken by the Asian American and the Hispanics respectively. In 2008, the CDC released the latest data showing the incidence of the disease among different ethnic groups. American white women still had the highest incidence rate followed by the African Americans.
The third group that had significantly a high incidence rate was the Hispanic followed by Asian/Pacific Islanders and the Asian Americans. However, the mortality rates due to the disease differed significantly. Research has shown that the African American women exhibited the highest mortality rates followed by the White women.
Following the report issued in 1998 via the ‘report card’, the American Cancer Society embarked on a more detailed research to unveil the cancer problems specific to each of the ethnic groups with much emphasis on the African American women since the breast cancer mortality rates were highest in this group. The National Cancer Institute has played a pivotal role in the reduction of the effects of cancer across all the ethnic groups in the US.
Its sole responsibility is to conduct research on the detection, treatment and control of the disease. Additionally, it conducts research on the prevention of cancer. To achieve its goal, it has sponsored several research agencies an aspect that has led to the discovery of many aspects as far as breast cancer is concerned. The research has led to the discovery of more breast cancer detection and diagnosis techniques.
It has also led to the development of better programs as far as better supportive care and improved treatment for patients is concerned. The development of the new technologies assisted in the reduction of the severity of the disease among the different ethnic groups. According to Jones and Chilton, the discoveries have not equally benefitted the various ethnic groups since the African American women are still endangered by the disease (539).
For instance, between the African American women and white women, there has been a great disparity in the rate of breast cancer survival for decades. With the exception of the African American women, the other groups had a positive response to the new mode of technology. African American women have continued to be disproportionately affected by the fatal disease.
The incidence and effect of breast cancer among some specific groups
As aforementioned African American women are disproportionately affected by the disease. Research has shown that it has been one of the leading causes of death among the women in this particular ethnic group.
Besides the impact of the disease in the society, women and their immediate family members have to endure the deep emotional effect imposed by not only the disease but also its treatment. Families also dread the recurrence of breast cancer. The incidence of the disease has been increasing over the last several decades (Cunningham et al 4).
For instance, from 1973 to 1998, the incidence of breast cancer among black women increased by over 40%. Despite all the efforts that the health system has made in the fight against breast cancer, African American women still continue to suffer from the effects of the disease. Research has shown that breast cancer is the second leading cause of cancer related death Among the African American women-the first cause is lung cancer (Jones, and Chilton 540).
Different ethnic groups consist of several sub-groups. Research has shown that, these subgroups exhibit different rates of breast cancer. As aforementioned, the Asian Americans have a relatively low rate of the breast cancer incidence as far as the ethnic groups in the US are concerned. Within the Asian ethnic group, the rates of breast cancer incidence vary by specific ethnicity with the Japanese women recording the highest rates while the Laotian women have the lowest rate.
Additionally, the place of birth of the members of a given ethnic group also determines their risk of developing breast cancer. For instance, during the period between 1988 and 2004, the breast cancer rates were higher for the US-born Filipina and Chinese women than their foreign-born counterparts (Gomez et al. 126). This trend was also true for the US borne and Foreign-born Japanese. However, the US-born Filipina recorded the highest rates of breast cancer incidence during that period-80%.
Factors that cause the differences in breast cancer incidence among ethnic groups
Socioeconomic factors vary among the various ethnic groups. This includes aspects such as the average income level of the members of a given ethnic group, lack of proper infrastructure e.g. poor means of transportation as well as lack of proper healthcare facilities.
This also includes the availability of screening programs within the available healthcare facilities. For instance, African American women have poorer socioeconomic status among the African Americans than the whites. African American women also have reduced access to health care services.
As compared to White women, African American women have a lower frequency of mammography with delayed diagnosis. Additionally, they tend to have reduced chemotherapy dosage which is associated with underlying neutropenia. For both White and African American women who have access to the same health care facilities and programs, other factors contribute to the high mortality rates among the African Americans due to the disease (Chen et al. 440).
Furthermore, the African Americans tend to have a much higher rate of high-grade cancers than the white women. In most cases, the breast cancer among the African American women tends to be ER negative posing a great danger to the victims. Several socioeconomic factors hinder the ability of the ethnic groups to access routine preventive health care programs.
Different ethnic groups differ in their ability to access routine preventive health care programs. A relatively high percentage of African Americans and Hispanics do not have access to proper health care. In some cases, they do not have a primary care provider.
The importance of a primary care provider is to enhance proper preventive care through the provision of routine check-ups and breast cancer screenings. Preventive care enables the detection of breast cancer at an early stage, which can be easily treated as opposed to the advanced stage-less treatable.
One of the factors that contribute to such is a strong belief, cultural or religious, related to their health and their health care. Some of the ethnic groups have strong beliefs in some supernatural healing and miracles. Religious/cultural beliefs impair individuals from participating in the routine preventive programs offered in the health care sector.
Women who hold such strong beliefs in healing and miracles do not have faith or rather do not trust the health care system. In most cases, they end up as breast cancer patients since they will only turn to the health care system probably at the advanced cancer stages. Generally such women in the group or sub-group do not participate in any form of routine preventive health care increasing the rate of breast cancer incidence in the ethnic group.
Communication barrier, the inability to understand another person’s language, impairs an individual’s ability to seek medical assistance. Consequently, women may fail to discuss their health concerns with medical practitioners impairing the preventive program since. In some cases, the interpreter may not be able to enhance comprehensive communication between the two parties in question. This might lead to lack of proper health care for the patient.
Most people lack the knowledge or rather the understanding of not only the symptoms but also the health care risks associated with breast cancer. Research has shown that most of the women who seek medical attention only during the advanced cases of breast cancer lack the knowledge of the symptoms of breast cancer in the early stages. Most American Hispanic Women are less aware of the risks of breast cancer. This prevents them from seeking medical attention in advance.
Some of the ethnic groups are deeply rooted in cultural practices. Such practices include traditional medicine that they believe are capable of addressing all their healthcare needs. In such groups, women who experience abnormalities in their breasts give first priority to the cultural practices rather than doctors. Owing to this, the fail to get proper medical assistance in time an aspect that puts their life at a great danger.
Reduction of the rates breast cancer incidence in all the ethnic groups
The rates of breast cancer can be reduced by the reduction of the main causative of the disease. Research has shown that the high prevalence of obesity is associated with breast cancer across all the ethnic groups. America has recorded the highest rates of obesity in the world.
According to Blackburn and Walker, 74.6% of Americans are obese with obesity being one of the leading causes of death in the nation (207). Obesity is one of the diseases that have led to the current crisis in the American healthcare system especially by causing other diseases among which is breast cancer. The medical expenditures associated with obesity in the nation are approximately $70 billion, which translates to more than a quarter of the American healthcare system’s expenditure.
Wolf and Colditz argue that America has suffered a loss of 40 million productive workdays and an additional 63 million days due to the frequent visits that obese individuals make to the doctor(s) (100). In an attempt to curb breast cancer and other forms of cancer associated with obesity, the American healthcare system has developed the ‘CARE’ policy whereby ‘CARE’ stands for Communication, Action, Research and Evaluation.
The policy aims to increase life expectancy by increasing both the quality and the years of healthy living of the Americans. Some of the key issues that the policy seeks to attain are improvement of the nutritional value of foods in major educational institutions; ensure the availability of physical education facilities not only in schools but also in public recreation centers; ensure more intensified research on the causes of the disease and bringing the findings to public attention.
The policy also advocates for education of healthcare professionals and students on the prevention, management and the treatment of the disease together with its related conditions such as breast cancer. Moreover, the policy incorporates the need for more research on the prevention and the treatment of obesity.
This paves way for new methods of dealing with the epidemic in the nation. It also calls for the promotion of health and nutrition related curriculums in high schools besides raising awareness of the two diseases and preventive screening of all individuals in America. The policy addresses the special needs of the elderly obese individuals in the nation in one of its initiatives-Healthy ageing initiative: Eating better and moving more.
Conclusion
Different ethnic groups have different rates of breast cancer incidence. As aforementioned, the white women have the highest incidence rates followed by the African American women. The Hispanics and Asian Americans have relatively low rates of breast cancer incidence.
However, African American women have the highest mortality rates associated with breast cancer. As discussed above, the specific groups within a given ethnic group also have different breast cancer incidence rates. Additionally, the place of birth of an individual also determines his/her ability to develop breast cancer. For instance, among the Asian American women during the period between 1988 and 2004, the breast cancer rates were higher for the US-born Filipina and Chinese women than their foreign-born counterparts.
There are many causes of the variation of breast cancer incidences across different ethnic groups. However, research is yet to establish the exact cause of the variation. Most researchers have attributed the variation to diet and lifestyle, genetic make-up and socioeconomic status. The American healthcare system has embarked on addressing obesity, which cuts across all the ethnic groups, in an attempt to curb the disease.
Annotated Bibliography
Cunningham, Ruth, et al. “Ethnic and Socioeconomic Trends in Breast Cancer Incidence in New Zealand.” BMC Cancer, 10. 694(2010): 1-10. Print.
The article includes a study of the incidence of breast cancer in New Zealand. It utilizes data from the New Zealand cancer registry for the period between 1981 and 2004.
The authors also compare the trend of the rates of the breast cancer incidence of the groups in New Zealand with those of the same groups in other parts of the world with a bias on the U.S. It also explains some of the socioeconomic factors that influence the breast cancer incidences in the different ethnic groups.
Gomez, Scarlet et al. “Hidden Breast Cancer Disparities in Asian Women: Disaggregating Incidence Rates by Ethnicity and Immigrant Status.” American Journal of Public Health, 100.1 (2010): 125-131. Print.
It focuses on the breast cancer incidences for specific Asian Populations in California. The data employed in this study was obtained from the Californian Cancer Registry for the period between 1998 and 2004. The information also included the immigration details of the sample group. The data was used to determine the rates of breast cancer incidences within the specific groups of the Asian Americans. It is a good source of information since California is the home of the largest number of Asian Americans in the U.S.
Jones, Lovel, and Chilton, Janice. “Effect of Breast Cancer on African American Women: Priority Areas for Research in the Next Decade.” American Journal of Public Health, 92. 4(2002): 539-542. Print.
It compares the rates of incidence of breast cancer incidence between the African American women and white women. It utilizes data for the Center of Disease Control and the National cancer Institute in giving the trend of the rates among the two groups of women. It also gives some of the causes of the disparities obtained from a research conducted by the National Cancer Institute.
Works Cited
Blackburn, Lawrence, and Walker, Williams. “Science-based Solutions to Obesity: What Are The Roles of Academia, Government, Industry and Healthcare?” The American Journal of Clinical Nutrition, 82.1. (2005): 207-210. Print.
Chen, Zao et al. “Ethnicity and Breast Cancer: Factors Influencing Differences In Incidence and outcome.” Journal of the National Cancer Institute, 97. 6 (2011): 439-448. Print.
Cunningham, Ruth, et al. “Ethnic and Socioeconomic Trends in Breast Cancer Incidence in New Zealand.” BMC Cancer, 10. 694(2010): 1-10. Print.
Gomez, Scarlet et al. “Hidden Breast Cancer Disparities in Asian Women: Disaggregating Incidence Rates by Ethnicity and Immigrant Status.” American Journal of Public Health, 100.1 (2010): 125-131. Print.
Jones, Lovel, and Chilton, Janice. “Effect of Breast Cancer on African American Women: Priority Areas for Research in the Next Decade.” American Journal of Public Health, 92. 4(2002): 539-542. Print.
Wolf, Arnold., and Colditz, Gregory. “Current Estimates of the Economic Cost of Obesity In the US.” Progress in Obesity Research, 6 (1998): 97-106. Print.