 |
||||||||||||||||||||||||||||||||||||||||||||||||||
|
Breast Cancer and Ethnic Diversity
Ethnic background plays a pivotal role in determining the manner in which breast cancer may impact a woman’s life. A number of differences have been found in the health risk factors occurring in various ethnic groups. Recent studies indicate African-American women have a slightly lower overall incidence rate than Caucasian women (see table), yet they have a higher rate of mortality and a higher rate of incidence among women under the age of 45. Women of European Jewish origin reportedly have a higher incidence of BRCA1 and BRCA2 gene mutations. As of yet, there is no clear consensus as to the role the environment, genetics or access to health care may play in creating these variances. Knowing that early detection is currently the only tool we have in our fight against breast cancer, several efforts have focused on the importance of screening mammograms, clinical breast exams, and breast self-exams. Despite these efforts, several gaps remain in the process that prevent us from properly reaching a number of special populations. For some groups, language is a barrier that makes communication between patients and health professionals quite difficult. While a number of hospitals have excellent translation departments, there are many others that will use anyone who is bilingual as a translator. Many women bring their children along to translate for them, which not only raises concern over the accuracy of translation, but also the impact such information may have on the child. Patients have reported that some hospitals even ask their house-keeping personnel to translate, which again my result in an inaccurate translation, not to mention the lack of compassion and support that are integral parts of the diagnostic and treatment process. A number of cultural barriers exist as well. Statistics reveal that while the immigration movement at the beginning of the century was comprised primarily of Europeans, there has been a significant shift toward people immigrating from both Latin-America and Asia. Early indications reveal many of these new groups of immigrants are not adapting as quickly to the influence of American culture as their European predecessors did, creating more than just a language difference to overcome. We need to find methods of breaking through these differences. We must also encourage the health care community to change the manner in which medical statistics are tracked. Up to this point there has been little, or no, ethnic differentiation used when collecting the data, thus we have no clear and accurate statistics for individual population groups. As the people in these groups comprise a significant percentage of the United States population (see table), this mater deserves immediate attention. While this population breakdown shows the number of individuals in each ethnic category, it may not reflect the diversity of cultures and acculturation levels within each group. For example, “Hispanic” is a generic term originally created by the Census Bureau to designate persons of Spanish origin or descent. This term barely existed before 1970. It was refined in 1980 to include Portuguese and Latin Americans, and then again in 1985 to include: Mexicans or Mexican Americans, Puerto Ricans, Cubans or Cuban Americans, Central or South Americans and any other Spanish/Hispanic group. Even when statistics were collected for this broad ethnic group they did not allow for the vast diversities within the Latino community. A number of other mixed ethnic groups exist as well. The African-American group includes Caribbeans, Africans, and Black Latinos. Asian-Americans represent more than twenty ethnic groups with origins in East Asia, Southeast Asia, Polynesia, Melanesia, and Micronesia. Native-Americans or American-Indians are said to represent a very small percentage of the US population; this may not be accurate, however, since some states actually deny the existence of this group. Population statistics on Native Americans are collected only by Indian Health Services, meaning only people enrolled in a federally recognized tribe are counted. In addition, many American-Indians are classified as Hispanic, due to their surname. Place of residence appears to have a significant impact on a woman’s risk factor as well. For instance, it has been found that Asians and Pacific Islanders, who have a substantially reduced rate of breast cancer incidence, increase their risk of developing breast cancer by 60% when moving to Hawaii, and by 80% when moving to San Francisco. Studies to date have shown no conclusive evidence that points to a reason(s) for this dramatic increase in risk when leaving one’s home land, nor have they found the reasons behind the many other ethnic disparities. The medical community is attempting to solve these puzzling dilemmas. Health care professionals have begun investigating more efficient means of collecting data and are currently developing new ethnic related studies, all in an attempt to find the answers which will enable them to better address the unique needs of each individual woman.
|
||||||||||||||||||||||||||||||||||||||||||||||||||
 |
||||||||||||||||||||||||||||||||||||||||||||||||||
|
Copyright © 2000 Bay Area Breast Cancer Network. All rights reserved. [Home] [We're Here] [Breast Health] [News & Views] [Voices] [Make a Difference] |
||||||||||||||||||||||||||||||||||||||||||||||||||