Studies of breast cancer risk and treatment outcomes are not taking sufficient account of race/ethnicity, economic status, education level, health insurance status and other social factors, according to scientists at Johns Hopkins Bloomberg School of Public Health.
The Bloomberg School scientists, in a commentary that appears in the July issue of Cancer Causes & Control, point to evidence that social factors help determine people’s vulnerability to cancer, and argue that these factors should be considered routinely in studies and risk assessments that bear on clinical care.
“We’ve been missing opportunities to understand and reduce disparities in breast cancer risk and outcomes,” says lead author Dr. Lorraine T. Dean, an assistant professor in the department of epidemiology at the Bloomberg School. “Simply put, not enough is being done to understand how race, income level and other social factors tie in to cancer susceptibility.”
A 2014 review of over 20 years of National Cancer Institute clinical trials, for example, found that only about 20 percent of the randomized controlled studies reported results stratified by race/ethnicity. In a follow-up analysis of 57 breast cancer observational and randomized controlled trials that were published in 2016, the researchers found that, after excluding those in which the primary focus was disparities, fewer than 5 percent of studies reported findings stratified by race or other socioeconomic factors.