Cancer death rates have gradually declined among women in the U.S. However, Black women still face undue barriers to detecting breast cancer.
University of Pennsylvania research scientist Dr. Christa Mahlobo conducted a community survey of nearly 1,000 participants to assess communication from health care professionals and examine what drives health decisions for Black women.
“Breast cancer is both pervasive and deeply personal in the Black community. Nearly two-thirds of survey respondents either have been diagnosed with breast cancer themselves or know someone close to them who has faced the disease,” said Dr. Mahlobo in Understanding Breast Cancer Risks, Concerns, and Barriers to Screening in Black Women, her breast cancer research. “Despite this, significant barriers stand between Black women and the screening and care that could save their lives.”
Her survey found that barriers to early breast cancer detection for Black women include costs, distrust of the health care system, and providers who don’t raise the topic. Roughly three-quarters of survey participants stated that their primary care physician did not discuss breast cancer testing.
Breast cancer was both the most commonly diagnosed cancer in Black women and the leading cause of cancer deaths among the same group in 2022. Research shows that approximately one in nine Black women will receive the diagnosis in their lifetime, and Black women are more likely to face it at a younger age than white women.
“Please listen to your African American patients, and believe their concerns and symptoms. Breast cancer does not wait until you are a certain age to invade you. You can save more lives by listening to your patients.” opened her report. “That’s what one Black woman told us when we asked what she’d say to her doctor if she could speak freely about breast health. We found she’s not alone in feeling unheard.”
Dr. Laura McCullough, co-principal investigator for the American Cancer Society’s VOICES of Black Women study, noted that anxieties and fear around breast cancer screenings are informed by both personal and historical experiences.
“For many Black women, fear is shaped by lived and historical experiences, including knowledge of worse outcomes in their communities,” McCullough said. “So, it’s fear informed by context, not simply fear of a test.”
She cited the urgency for health care systems to utilize strategies that build trust, access, and agency for Black women. The American Cancer Society’s community-engaged navigation, peer testimonials and survivor visibility, and clear follow-up pathways were examples she provided.
“When systems reduce ambiguity and increase trust, fear becomes more manageable,” the doctor noted.
Dr. Mahlobo is optimistic that expanding early detection will save lives and that the technology will continue to improve.
“Breast cancer incidence numbers have been on a decline since 1989, with ebbs and flows. There’s been an increase in early detection and improved mammogram screening ability,” she continued. “That gives me hope that we could see a large reduction in breast cancer mortality rates in Black women as well.”
Read the Breast Cancer Risks and Screening Barriers for Black Women report in full here.
