Breast cancer guidelines could harm black women

The new screening recommendations are questionable for all women, but especially African-American ones

Published November 19, 2009 7:20PM (EST)

On Wednesday, Broadsheet's Mary Elizabeth Williams laid out some good reasons to be skeptical of The U.S. Preventive Services Task Force's new guidelines for breast cancer screening, which suggest mammograms every two years for women 50-74, as opposed to every year for women over 40. Although "the report does make a persuasive case that not all cancers are life-threatening, and that 'over detection' and 'over treatment' pose their own -- often considerable -- health risks," Williams says, "What's optional for one woman may be the difference between life and death for another." And sometimes, says Ashton Lattimore at NewsOne, race will be the factor that determines which woman is which. "Perhaps even more than others, one group has particular cause to be wary [of the new guidelines]: Black women."

Black women, writes Lattimore, "have the highest breast cancer death rate of any race, are at increased risk for developing the diseases at younger ages, and are disproportionately prone to an extremely aggressive form of breast cancer" known as "triple negative," which can move fast enough to progress beyond stage 1 in between annual screenings, let alone biannual ones. Additionally, African-American women "already receive fewer mammograms than white women," are more likely to be diagnosed at later stages and less likely to receive the appropriate follow-up care. Moreover, "the U.S. Department of Health reports that Black women ages 35 to 44 have a breast cancer death rate more than twice that of white women in the same age group."

According to Marisa Weiss, M.D., director of Breast Radiation Oncology and director of Breast Health Outreach at Pennsylvania's Lankenau Hospital, delaying screening until age 50 and extending the length of time between mammograms "could have a devastating effect on African-American women." Alexine Clement Jackson, writing in Essence, agrees. "As a breast cancer survivor myself, and chairman of the [Susan G. Komen for the Cure] Board of Directors, I urge all women, but especially African-American women under 50, to pay attention to their breast health."

Fortunately, Secretary of Health and Human Services Kathleen Sebelius has stated that Medicare will continue to cover breast cancer screening according to the old guidelines, and she "would be very surprised if any private insurance company changed its mammography coverage decisions as a result of this action." (That makes one of us.) The New York Times reports that in a statement, Sebelius "stressed that the task force 'is an outside independent panel of doctors and scientists who make recommendations' and who neither 'set federal policy' nor 'determine what services are covered by the federal government.'" That's good. What would be even better is if doctors and scientists -- and the journalists who report on their findings -- kept in mind that public health recommendations for women need to take more than just white women into account.


By Kate Harding

Kate Harding is the author of Asking For It: The Alarming Rise of Rape Culture--and What We Can Do About It, available from Da Capo Press in August 2015. Previously, she collaborated with Anna Holmes, Amanda Hess, and a cast of thousands on The Book of Jezebel, and with Marianne Kirby on Lessons from the Fat-o-Sphere. You might also remember her as the founding editor of Shapely Prose (2007-2010). Kate's essays have appeared in the anthologies Madonna & Me, Yes Means Yes, Feed Me, and Airmail: Women of Letters. She holds an M.F.A. in fiction from Vermont College of Fine Arts and a B.A. in English from University of Toronto, and is currently at work on a Ph.D. in creative writing from Bath Spa University

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