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Women with low incomes are more likely to be diagnosed with late stages of breast cancer, receive different treatments, and die from the disease than women of higher economic standings, according to a recent study published in the Journal of the National Cancer Institute. Researchers had previously found African-Americans more likely to be diagnosed with advanced breast cancer than White women. However, the new study results are significant because they show that income level, not race, plays the primary role in late diagnoses, treatment options, and deaths from breast cancer. To conduct the study, Cathy J. Bradley, PhD of Michigan State University and her colleagues cross-referenced data from a Michigan cancer registry with the Michigan Medicaid enrollment file, a healthcare program for low-income women. They found that 593 women of 5,719 were insured by Medicaid. Dr. Bradley and her team then analyzed factors such as race and poverty and compared them with information about the women's cancer diagnoses, treatment, and survival. Of the nearly 6,000 women in the cancer registry, African-American women were 53% more likely to be diagnosed with advanced breast cancer and nearly 40% more likely to die from the disease, compared to White women. African-Americans were also less likely to receive breast cancer surgery or radiation after surgery than White women. Those African-Americans who did undergo surgery were more likely to have breast conserving surgery (lumpectomy) than mastectomy. However, when factoring in the Medicaid data, Dr. Bradley and her colleagues found that economic status was a much more substantial factor than race in cases of late diagnoses and breast cancer deaths. Women on Medicaid were significantly more likely to be diagnosed with advanced breast cancer and over 60% more likely to die from breast cancer than women with higher income levels who had private health insurance. (Uninsured women were even more likely than Medicaid recipients to be diagnosed with late-stage breast cancer). African-Americans were still less likely than White women to receive breast cancer surgery, even when the researchers factored in the Medicaid data. Experts say the study illustrates the crucial need to provide better medical care to the poor. While the study found low economic status, not race, contributed later breast cancer diagnoses, a higher percentage of African-Americans live in poverty compared with Whites. In the study, 84% of African-American women had low income levels versus only 13% of White women. Women with low income levels are encouraged to take advantage of the Centers for Disease Control’s (CDC) National Breast and Cervical Cancer Early Detection Program, which provides access to free preventive mammograms and Pap smears for qualifying women. The program also covers treatment of cancers detected through the screening program. Cancer organizations are working to spread the word about this program in poor communities.
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