News | Women's Health | July 11, 2018

New analysis of breast cancer studies published in 2016 found that fewer than five percent were stratified by race, socioeconomic factors

Breast Cancer Studies Ignore Race, Socioeconomic Factors

July 11, 2018 — A new commentary appearing in the July issue of Cancer Causes & Control points to evidence that social factors help determine people’s vulnerability to cancer. The commentary, by scientists from the Bloomberg School, also argues that these factors should be considered routinely in studies and risk assessments that bear on clinical care.

"We've been missing opportunities to understand and reduce disparities in breast cancer risk and outcomes," said lead author Lorraine T. Dean, ScD, an assistant professor in the Department of Epidemiology at the Bloomberg School. "Simply put, not enough is being done to understand how race, income level and other social factors tie in to cancer susceptibility."

A 2014 review of over 20 years of National Cancer Institute clinical trials, for example, found that only about 20 percent of the randomized controlled studies reported results stratified by race/ethnicity. In a follow-up analysis of 57 breast cancer observational and randomized controlled trials that were published in 2016, the researchers found that, after excluding those in which the primary focus was disparities, fewer than 5 percent of studies reported findings stratified by race or other socioeconomic factors.

As Dean and colleagues note in their commentary, it should be obvious that in general, neglecting race/ethnicity and other social factors in medical research can mask important drivers of bad outcomes. For example, a recent high-profile study sorting mortality rates by race and socioeconomic status revealed that midlife mortality is increasing among blue-collar whites in the U.S. even though it is declining for the population overall. Those findings drew attention to ongoing increases in suicides and substance-abuse-related deaths for blue-collar whites, and led researchers to zero in on economic despair and social decay as the likely causes.

"A lot of scientists don't want to deal with race or socioeconomic position in their studies because they think those characteristics aren't modifiable," Dean said. "But they can actually help identify factors that are modifiable. You can't change your genes, for example, but we still do genetic studies because they illuminate pathways we can change with medicines or other interventions."

Breast cancers are the principal research focus for Dean and colleagues. They see the potential —and many missed opportunities to date —for research to uncover or at least address social-related risk factors for this set of diseases.

They point out, for example, that standard breast cancer risk assessment tools have not always taken race into account — even though there are significant racial disparities in the risks for certain types of breast cancer as well as breast cancer mortality rates. For many years, a commonly used questionnaire tool for assessing breast cancer risk (now known simply as the Breast Cancer Risk Assessment Tool) was validated only for white women. It tended to underestimate significantly the risks of breast cancers for black women, who have lower rates of mammogram screening and higher rates of breast cancer at younger ages. That error may have kept many black women from participating in cancer-prevention trials of drugs such as tamoxifen.

"The model was revised in 2015 to take race into account, and now estimates black female eligibility for chemoprevention at nearly three times the rate of the original model," said Dean.

Clinical trials and population studies should be powerful tools for uncovering links between social factors and cancer vulnerability, which in turn should lead to better risk reduction and/or treatment strategies. But here too, the necessary information is not routinely gathered.

To address the issue, Dean and her colleagues recommend:

  • Increasing education and awareness about the importance of inclusion of social factors in clinical research;
  • Adding requirements for data on social factors to journal guidelines for reporting study results; and
  • Refining cancer risk assessment tools by including social factors.

"If adopted, these measures would enable more effective design and implementation of interventions," Dean said, "and would help eliminate breast cancer racial and socioeconomic disparities by accounting for the social and environmental contexts in which cancer patients live and are treated."

For more information: www.link.springer.com

Reference

Dean L.T., Gehlert S., Neuhouser M.L., et al. "Social factors matter in cancer risk and survivorship." Cancer Causes & Control, May 30, 2018. https://doi.org/10.1007/s10552-018-1043-y


Related Content

News | Breast Imaging

July 7, 2025 — SimonMed Imaging, one of the largest outpatient medical imaging providers in the United States, has ...

Time July 08, 2025
arrow
News | Breast Imaging

June 25, 2025 — QT Imaging Holdings, Inc., a medical device company engaged in research, development, and ...

Time June 25, 2025
arrow
News | Mammography

April 29, 2025 — iCAD, a global provider of clinically proven AI-powered cancer detection solutions, has announced a ...

Time April 29, 2025
arrow
News | Mammography

April 24, 2025 — GE HealthCare will feature its latest advancements in diagnostic accuracy and patient-centered breast ...

Time April 24, 2025
arrow
News | Artificial Intelligence

March 10, 2025 — Lunit, a provider of AI-powered solutions for cancer diagnostics and therapeutics, has published a ...

Time March 10, 2025
arrow
News | Artificial Intelligence

Feb. 19, 2025 — SimonMed Imaging and HeartLung Technologies have signed a strategic partnership to offer HeartLung's AI ...

Time March 04, 2025
arrow
News | Ultrasound Imaging

Jan. 28, 2025 — GE HealthCare recently announced it has received 510(k) clearance from the United States Food and Drug ...

Time January 29, 2025
arrow
News | Breast Imaging

Jan. 8, 2025 — ScreenPoint Medical has acquiredf Biomediq A/S, a research-based company focused on the research ...

Time January 10, 2025
arrow
News | Breast Imaging

Dec.11, 2024 — iCAD, Inc., a provider of clinically proven AI-powered cancer detection solutions, recently announced ...

Time December 18, 2024
arrow
News | Mammography

Dec. 5, 2024 — At RSNA 2024, Lunit and Volpara Health announced their unified vision, focusing on a comprehensive ...

Time December 05, 2024
arrow
Subscribe Now