An investigation in the Global Mail concluded that “ In pretending we are ‘color blind,’ we have actually harmed Black Canadians by failing to study and address our health care disparities”.
In Canada, many Black Canadian women's lives are at risk because of the lack of healthcare data. Based on a recent wide-reaching review of medical literature, researchers went through 2,000 studies on cervical and breast cancer regarding Black Canadians. From these studies, only 23 studies from the past 15 years took into account the Black Canadian women's population. Only 23 studies! The lack of informative health care data on Black Canadians continues to put their lives at risk. Researchers also discovered that Black women often have breast and cervical cancer originating from different variants--even within the Black community, there are even more sub-variants that demand an independent investigation. The dearth of data on the differences within these groups of Black women leads to many cancer cases going unnoticed. Thus, Black women are not often incorporated into clinical drug trials even though their breast cancer might be a subvariant that demands further investigations as to new drug therapies.
Therefore, treatment and drug protocols and cancer policies cannot be accurately updated to help serve these at-risk communities. Taking this one step further, many healthcare providers cannot be adequately educated to effectively provide Black women with the best medical advice and service. Although in Canada, we are fortunate enough to have a free health care system, being named as one of the best healthcare systems in the world, the wellbeing of the Black women's community seems to be falling between the cracks.
Studies also suggest that many cases of breast cancer in the Black community go unnoticed due to underlying race-related biases and “mythologies” about black women and their bodies--one example is that 40% of first and second-year medical students validated the belief of “black people’s skin is thicker than white people’s skin” (Sabin, 2020). Based on Healthline's data, research has suggested that Black patients' breast cancer tumors tend to be larger in size and had already spread in the axillary (underarm area) lymph nodes. Why is that?
Currently, later-stage diagnoses are often a by-product of lower screening rates within the black community---doctors do not seem to order mammography as often as they do with white patients. So, Black patients are often diagnosed later with later-stage breast cancer and with a higher chance of metastases throughout their bodies. Many black women have sub-variants of breast cancer, such as triple-negative* breast cancer; it is twice as common in the Black community than the white, accounting for an estimate of 30% of new cases in Black women. Ultimately, there is a vital need for the voices and needs of the Black community to be heard and we need to address them.
What can we do?
We can start with calls to action on social media to encourage our fellow black women to get regular checkups, to press their doctors for breast exams and imaging. We can push NGOs and institutions to ensure that they are using research that has accurate data collection measures and statistics to implement a strategy to better help the Black community.
As a recent tweeter wrote, "A lot of providers [say] because it's not in our guidelines, it's not part of our practice." But breast cancer in the Black community is part of their healthcare practice. We need to demand change so black bodies and black lives are part of the research, are part of the trials, are part of the larger breast cancer community as a voice and face. Studies must include Black women as a part of research study groups. All of us--white or persons of color must advocate together for the health and wellbeing of Black women and men, not just with regards to breast cancer, but in all medical practices.
*Triple-negative breast cancer is cancer that tests negative for estrogen receptors, progesterone receptors, and excess HER2 protein. These results mean the growth of the cancer is not fueled by the hormones estrogen and progesterone, or by the HER2 protein. So, triple-negative breast cancer does not respond to hormonal therapy medicines or medicines that target HER2 protein receptors. However, there are treatments for triple-negative breast cancer (Source: breastcancer.org)
Hoffman, K. M., Trawalter, S., Axt, J. R., & Oliver, M. N. (2016). Racial bias in pain assessment and treatment recommendations, and false beliefs about biological differences between blacks and whites. Proceedings of the National Academy of Sciences, 113(16), 4296-4301. DOI: 10.1073/pnas.1516047113