Racial and ethnic disparities in breast cancer stage, treatment, and survival in the United States.

Several studies indicate that African-American, Hispanic White, and Native American women with breast cancer present with more advanced stages and have poorer survival rates than non-Hispanic Whites, while Asians/Pacific Islanders do not. However, Asians/Pacific Islanders and Hispanic Whites are heterogeneous populations, and recent data indicate that certain subgroups of these populations have poorer breast cancer outcomes compared to non-Hispanic Whites, while others have better outcomes. Many of these disparities have persisted for decades, but until recently, detailed studies exploring the reasons behind these disparities have been limited. The results of these studies point to the effect of differences in socioeconomic status, access to health care (including both breast cancer screening and treatment services), lifestyle factors, and tumor characteristics on these disparities. Thus, these studies indicate that these disparities are multifactorial, and therefore strategies aimed at reducing them must involve advocacy, research, education, and healthcare services. A key component to the success of these strategies is not only support for them on the federal and state levels, but also the involvement of local communities in developing programs and policies that are culturally and linguistically appropriate for their communities in order to ensure not only the utility, but also the longevity, of these efforts.