For treatment, it looked at racial disparities in access to medication, delays in treatment, dose reductions and discontinuation of treatment, all of which have been shown to be suboptimal more often in Black women, according to Chapman. She says that past recommendations have not accounted for how structural, interpersonal and internalized racism impacts breast cancer treatment, length of survival and deaths among Black women.

“One of the major issues in health equity research is that disparities have been described for decades, but there has been less attention on actually rectifying disparities,” said Chapman. “Funding and other resources are needed to support research to address disparities. Furthermore, policy changes will be required at many levels of society in order to address these disparities, as interventions that focus solely on the healthcare system will fall short of addressing upstream issues that lead to treatment and screening disparities.”

She adds that comparing information on screening practices across diverse populations may increase equity in cancer outcomes and that potentially tailoring interventions for specific racial groups may be needed for equitable care. “As far as our study is concerned, self-reported Black race has consistently been shown to correlate to disparities in breast cancer outcomes, so we feel that the use of self-reported race in our study was appropriate. So having more direct measures of racism may help more specifically identify those at risk of the types of racism that can affect breast cancer outcomes, but they might end up not being that much better than self-reported race for a sizable percentage of the population.”

The findings were published in Annals of Internal Medicine.

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