Since my own cancer diagnosis and treatment, I have spent a good part of my life listening to and supporting Black women battling breast cancer. It’s one thing to know the horrible statistics – that Black women have a more than 40% greater likelihood of dying from the disease than white women. It’s another thing altogether to help a fellow cancer survivor through their journey and know that their prognosis may be affected because their cancer wasn’t detected early enough.
Being part of women’s journeys and knowing their stories has made me passionate about the need to persistently bring attention to cancer disparities in the Black community and the importance of prevention and screening. The crisis we face today is that the pandemic has created its own form of silence in our communities, as people stay at home and avoid the interactions that could make them more vulnerable to the virus. Consequently, cancer has become an even greater health challenge, particularly for Black women and men.
During the pandemic, the number of mammograms being performed nationwide has dropped precipitously. The standard obstacles we face in convincing women to get screened – lack of health insurance, mistrust with the medical community, transportation challenges, finding childcare, and fear of the results – are complicated by a virus that makes people wary of going to a clinic or doctor’s office and being around other patients and healthcare workers. Compound the standard obstacles to care with the lack of health equity within our healthcare system and it’s clear that health outcomes will only improve once we have systemic and structural change.
If we want to reduce the racial disparity in this country when it comes to cancer deaths, we must find ways to make cancer screening more broadly accessible. Fortunately, medical science may be providing one of the answers. Healthcare companies like GRAIL and Thrive are developing groundbreaking technologies that utilize machine learning and genomic research to identify many cancers from a single blood test. These new tests, which would complement existing screenings, like mammograms, are currently undergoing clinical trials. Although more work needs to be done to ensure trials in genomic medicine reflect the diverse demographic makeup of our state and country, the progress we’re seeing in this field shows significant potential. A scientific journal recently published results of a study showing that GRAIL’s test had detected more than 50 cancer types. Knowing that this science is on the not-too-distant horizon, we have to encourage all parts of the healthcare system – doctors, clinics, and insurers – to be ready for it. Likewise, government officials need to ensure that Medicare and Medicaid, which provide insurance coverage to so many Black women, overcome existing obstacles to covering these tests.
Of course, it’s not only Black Americans that suffer from a lack of early detection for the vast majority of cancers. Yet compared to our white counterparts, we have a higher mortality rate for all cancers combined. Jaws dropped across the world when we found out about Chadwick Boseman’s four-year private battle with the disease. It highlighted the disparities within cancer care, particularly for Black men. The racial biases that exist and permeate through our everyday lives have a direct impact on quality of care and life. In addition, while colon cancer rates are decreasing overall, they are actually rising among younger adults. Yet screening guidelines haven’t caught up, even though Boseman was two years younger than the recommended screening age of 45 when he passed. We need to be able to detect all cancers sooner, before they show symptoms. New screening technologies being developed now would be a step forward toward that goal.
As someone who has been blessed with extra years made possible by early detection, being proactive, and the proper diagnostic tests and effective treatments, my greatest wish is that the women I have come to know, and will know in the future, experience the same opportunity. Today, Black Americans face inequities when it comes to cancer, as evidenced by our comparably higher rates of death from the disease. It’s up to us, and the medical and healthcare communities, to do everything within our power to beat those odds. Let’s make sure that we do.
Rhonda Smith, Interim Executive Director of the California Black Health Network, and a ten-year breast cancer survivor.