When Kwaku Ayisi lost a friend who hadn’t even reached 40 to breast cancer, it inspired him to look at the barriers Black women face in Saskatchewan’s breast-health system.
Ayisi, a researcher at the University of Regina, saw that Black women had much higher breast cancer mortality rates and wanted to know why.
He found that Black women are more likely to get breast cancer earlier in life, more prone to aggressive forms and have a higher mortality rate.
Ayisi also found a lot of systemic barriers: language, cultural beliefs and a lack of education on breast cancer.
Disproportionate consequences
The Canadian Cancer Society said a recent study found Black women in Canada are more likely to be diagnosed with breast cancer at a younger age, more likely to be diagnosed at advanced stages and more likely to have triple-negative breast cancer, which is harder to treat and associated with worse outcomes.
Data collected by the American Cancer Society found that while breast cancer rates are similar between Black and white women, Black women have a mortality rate roughly 40 per cent higher.
“Among women under 50, the disparity is even greater: While young women have a higher incidence of aggressive cancers, young Black women have double the mortality rate of young white women,” the Breast Cancer Research Foundation (BCRF) says on its website about the data.
BCRF says that while technology has reduced overall mortality rates, it hasn’t benefited all groups equally.
“Through continued research, it’s clear that biology also plays a role,” BCRF says.
Screening age coming down
Saskatchewan is in the process of lowering the age at which all women can be screened for breast cancer without specific concerns.
The province recently announced it would gradually lower the age limit for screening mammograms to 40 from 50. Anyone age 47 or above can now book a screening mammogram without a doctor’s referral. The limit will drop to 45 in June and continue to lower over time.
Saskatchewan’s Ministry of Health said in a statement that race is not a factor in breast cancer screening eligibility in the province. It said it eligibility ages are largely informed by national breast screening guidelines provided by the Canadian Task Force on Preventative Health Care.
“It currently recommends women aged of 50-74 should be screening regularly and women aged 40-50 should be provided information about the benefits and harms of screening to make a personal screening decision that aligns with their risks, values and preferences,” the statement said.
The ministry said anyone with symptoms of breast cancer or concerns should talk to their doctor about screening, regardless of age. It also said it welcomes any research and, “will take into account any findings of interest in future policy considerations.”
Ayisi wants to see race and ethnicity considered when breast cancer data is analyzed to inform policy in Saskatchewan.
He also wants more education on what breast cancer is, how it affects Black women differently from other groups and the importance of early mammography. He believes that could lead to more Black women seeking screening.
Early detection vital
Sonia Reid, a vocal coach in Saskatchewan, recently had her own cancer scare.
“I am an individual who benefits from the screening and is actively being screened as we speak because we have some concerns,” said Reid.
She agreed that early detection is vital.
“I love hearing the stories of, ‘oh, we caught it early enough.’ That’s what I want to hear,” she said. “I don’t want to hear, ‘I didn’t know until it’s too late,'” she said.
Reid said Ayisi’s work is very important for Black women like her.
“The access, and knowledge it would bring, and how that would just bring people’s mental health and their sense of wellness on a day-to-day basis to a higher level,” she said.
“When you’re walking through life and obscurity, not knowing, maybe you’re not feeling well, maybe something seems off, but you’re not sure of what to do. That’s not the place you want to be.”