The Ethical Phenomenon Of Breast Cancer Screening And Treatments

Although survival rates of breast cancer are improving, it is occurring at a slower rate for minorities (O’Keefe et al., 2015). Recommendations on when to begin mammography screenings vary slightly with greatest consensus for women with average risk to begin annual screening at 40-years-old. Fewer minority women adhere to mammography guidelines than white women and an even greater gap exists for those above and below the poverty line (Kerans, 2004). Based on evidence from a systematic review of 88 studies, the Community Preventive Services Task Force (CPSTF) recommends multicomponent interventions for breast cancer screening for the greatest impact on underserved

Why should we care? According to (Bender, 2012) 40,000 women and approximately 390 men will die this year from breast cancer. Cancer does not discriminate; it could be someone you know. It could be you.

Early detection, screening and prevention, often times is not provided by mainstream America to support programs that benefit all American’s. Often Minority groups are sometimes five years after preventative screening before tests are available to

Low income neighborhoods are still witnessing a rising gap in healthcare coverage. For example, patients with diabetes are more likely to undergo limb amputation than those in higher income areas (Pearl, 2015). Also, research has shown the Caucasians women have and overall incidence of breast cancer that is higher than that of African American women (Williams, Mohammed, Leavell, & Collins, 2010). On the contrary there is a higher death rate of breast cancer in African American women than in Caucasians women.

The North Carolina-Based Breast Cancer Screening Program (NC-BCSP) was questioning if they could increase African-American women’s access to breast cancer screening, would this help women determine their risk factors and seek further screening process? The goal was to decrease the obstructions of the women in North Carolina to everyday health care, but at the same time increase women’s access to breast cancer screening, while making connections that could help women across the state. The evaluated outcomes was to implement an education process so that there was a tracking system that would determine if the participants were at the human health center and clinic for their initial visit or a repeat visitor.

Findings in a report with dates from 1975-2003 reported “data on socioeconomic status (SES), behavioral risk factors, and cancer screening by race, ethnicity, and Mexican, Puerto Rican, and Cuban groups”2. Not having access to healthcare is one of the leading factors of why cancer rates among the Hispanic/Latino population is so high. In fact, “Latinos are less likely than non-Latinos to have health care coverage, especially when they are younger than 65 years”2 because of their income. And “Hispanic persons are much less likely to have a regular source of medical care than are non-Hispanic populations, with Latino men being the least likely”2. “Access to state-of-the-art, quality cancer care is known to be unequal and to exacerbate existing disparities in cancer outcomes”2 which is unfair and

African Americans carry an uneven share of the cancer load in the United States, having the highest death rate and shortest survival of any racial or ethnic group for most cancers. In this article, I will provide updated data for African Americans on cancer rate, death, survival, and cancer screening. I also estimate the total number of deaths prevented among African Americans as a result of the decline in cancer death rates since the early 1990s.

The National Cancer Institute provides great examples of cancer health disparities and the burdens each ethnic group face. Factors such as education, living conditions, exposure to environmental toxins, workplace, and access to healthcare can influence the survival rate and mortality rate of those diagnosed with cancer. More so, medically underserved populations face the most burdens resulting in late diagnosed or no treatment at

Nature and scope of the project: Despite the advances in medical technology, breast cancer is the most common cancer among women and is the second cause of mortality in African-American and Caucasian women in the United States. Mammography has shown to be one of the best method to reduce late detection of breast cancer. The American Cancer Society recommends monthly self-breast examination (SBE), clinical breast examination every three years and mammography starting at age of 40. Despite the recommendations, there is a disparity among different racial groups. The breast cancer screening rates are higher in certain subgroups, including low-income African-Americans and Hispanic

As stated previously in 2014 the USA had approximately 20.3 million people who were diagnosed with cancer. When exploring the 2013 incident rates of men with cancer black men had an incident rate of 518. Compared to white men of 473.9, next came Hispanic and Asian; black males had the highest death rate among all races (Centers for Disease Control and Prevention, 2016b). In regards to women, white women had an incident rate of 417.4, followed by blacks, Hispanics, and Asians, but the highest death rate is among black women (Centers for Disease Control and Prevention, 2016b). According to the statistics the needs for increased screening and care is needed in the African American and Hispanic community.

Mammography, the most effective method for detecting breast cancer at its early stages, can identify malignancies before they can be felt and before symptoms develop. According to the report, from 2000 to 2010, the percentage of women who received a mammogram decline for women from poor and low-income households and for non-Hispanic whites. Furthermore, women from poor, low-income, and middle-income households were less likely to receive a mammogram compared with women from high-income households. In National Healthcare Quality Report (NHQR), among women ages 50-64, uninsured women were less likely to receive a mammogram compared with those with private insurance. The two main factors that serve as a barrier to early detection and cure for breast cancer are socio-economic status (no health insurance/poor access to healthcare) and lack of awareness of the importance of breast cancer screening. The impact of these factors is to the patients and their families is that frequently, breast cancer would be detected at an already advanced stage and the prognosis would be poor, leading to mortality. Cancer diagnosed early before spread has occurred are generally more amenable to treatment and cancers diagnosed late with extensive spread have poor prognoses. In these cases, treatment would just be of palliative in nature. Early detection through screening means early treatment and lower mortality

Sarah Boseley explains how white women have a high greater chance getting breast cancer than those blacks and south Asian women. The author mentions that women from ethnic groups such as "blacks," "whites," and "south Asian" being recruited from since 1996 to 2001. However, the large population who has breast cancer is white women. Analyzing the data from women's study at the University of Oxford, Boseley argues how women have a better chance to protect themselves, nevertheless by breastfeeding their babies and also to plan having a large family. Consequently, she also suggests all women's need advice from the Cancer Research Center in United Kingdom and these women are insensible of terrible disease. This sources urges us to understand significant

Although African Americans have the same rate of incidence of cancer as Whites, African Americans commonly believe that they are less likely to have cancer. (Black Americans' Attitudes Toward Cancer and Cancer tests: Highlights of a study 212) This stems from the idea that cancer is a white person disease while diabetes and sickle anemia are black person diseases. “Beliefs about cancer may influence the perception of risk of developing the disease, and participation in screening programs” One’s beliefs are often developed from one’s culture. This cultural belief in addition to others, causes African Americans to be less likely to screen for cancer. As seen in a study about screening Colorectal Cancer, African American participants were less likely to screen for Colorectal Cancer due to the belief in cancer fatalism, which is to say that one will certainly die from cancer (Shavers, Brown 334). Lack of health literacy also contributed to disinterested in cancer screening, this lack of knowledge may stem from low SES that affects many African Americans or once again the disinterest in cancer as a disease that majorly affects black people. It is important to understand that African American culture to understand and therefore make screening more available to black people without fundamentally changing African American

In their article entitled "Race and Ethnicity and Breast Cancer Outcomes in an Underinsured Population" (2010), Komeneka et al. retrospectively examined a group of uninsured and underinsured breast cancer patients in order to determine whether there were statistically significant differences in breast cancer survival rates between African-American and non-Hispanic white women of similar underinsured status. The authors determined that the previous literature concerning differences in breast cancer according to race did not sufficiently take into account equal access to healthcare. To eliminate the variable of access to healthcare, the researchers limited their participants to those who were either uninsured or underinsured at the time of diagnosis. They also controlled for disparities in treatment by selecting patients who had been treated at one hospital by the same physicians using the same diagnostic methods. The authors found that, while there was a statistically significant decrease in breast cancer-related survival among African American women as compared to non-Hispanic white women in the study, this difference became statistically insignificant when age at diagnosis, clinical stage, hormone receptor status, and sociodemographic factors such as employment and education were taken into account. They concluded that the statistically significant difference in breast-cancer related outcomes between underinsured African American and non-Hispanic white women could be

Despite the difficulty, researchers have reported the benefits of screening. The most recognized benefit of health screening according to Durojaiye, (2009) is it’s effectiveness in reducing morbidity and mortality from disease by detecting it before symptoms occur. A report in 2006, by the Advisory Committee on Breast Cancer Screening, shows that screening saves 1,400 lives a year in England. In Australia, The age-standardized breast cancer mortality rate in women of all ages declined significantly from 28 per 100,000 women in 1996 to 24 per 100,000 in 2005. Mortality from breast cancer among women aged 50-69 was reported to have declined from 62 deaths per 100,000 in 1996 to 52 deaths per 100,000 in 2005 (Australian Institute of Health and Welfare, 2008) . Evidence also suggests that a reduction in death rates of around 95% is possible in the long-term with cervical cancer screening. The screening of pregnant women to identify and intervene early with risks to their health and that of their babies are associated with improved health status among high-risk populations (Durojaiye, 2009). The idea of screening therefore is to prevent, not to cure. Pope (1992), stats that screening is the second best option, but one which