Racial disparities among breast cancer cases in Edgecombe County, North Carolina, appear to be less profound than in 2007 when a seminal report on breast cancer was issued. However, while some positive change has been seen in ongoing local efforts to improve breast cancer awareness and care, other efforts continue to fall short.
Those are the findings of a new study led by a researcher from the University of North Carolina Gillings School of Global Public Health. The study focused on Nash, Orange and Edgecombe (N.C.) counties. A 2007 Susan G. Komen organization study identified Edgecombe County as having among the highest national incidences per capita of breast cancer and breast cancer mortality. Researchers found that in the years following the 2007 study, the county’s breast cancer incidence rate of 185.3 per 100,000 declined by 16 percent. The declines in the two comparison counties were much less dramatic.
Nash County, while bordering Edgecombe and like it, rural, has fewer African-American residents (37.2 percent) than does Edgecombe (55.9 percent). Orange County is more affluent than both and has more ready access to health care. These factors informed using the two counties for comparison with Edgecombe. The researchers believed the contrasts would offer insights into potential disparities in access to breast cancer information and care. Overall, results were somewhat encouraging.
“It may have been that the 2007 study marked a high point in breast cancer incidents, sounded an alarm or both, but whatever the case, we’ve seen a marked decline since then,” said Dr. Anissa I. Vines, assistant professor of epidemiology at UNC’s Gillings School and the study’s lead author. “There definitely was an increase in efforts to disseminate information about breast cancer diagnosis and treatment, especially among the African-American community in the time since that report was issued. It wasn’t just one person or one organization, but multiple organizations with a shared desire to address the concerning breast cancer rates in Edgecombe County. Everyone from organizations in the community were willing to work together, leverage the support of each other and really tackle this situation.”
[Photo: Dr. Anissa Vines]
Dr. Vines is quick to add that more work needs to be done, and the data support that fact. Women in Edgecombe and Nash counties still were more likely to be diagnosed with advanced stage breast cancer than women in Orange County. African-American women in Edgecombe and Nash counties were diagnosed with advanced stage cancer more often than African-American women in Orange County, as well.
Dr. Vines says that, as is the case in most rural counties, and for African-American women specifically, improving early access to information, diagnosis and care are essential to continue any improvements.
“Ongoing surveillance of breast cancer outcomes and the influx of scientific advances from breast cancer research to the community also will be critical to supporting local efforts,” Dr. Vines said. “Likewise, resources to support community grassroots efforts and community-academic research partnerships are also necessary.”
The study, “Responding to a Community’s Concern: A Comparison of Breast Cancer Characteristics and Initial Treatment in Three Selected North Carolina Counties,” appeared in a recent issue of the North Carolina Medical Journal. Study co-authors included Dr. William R. Carpenter, adjunct associate professor of health policy and management at the UNC Gillings School and member of the UNC Lineberger Comprehensive Cancer Center, and Dr. Ronald C. Chen, associate professor of radiation oncology, member of UNC Lineberger and senior fellow at UNC’s Cecil B. Sheps Center for Health Services Research.