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Wisconsin has had little success in eliminating what a new report in the Wisconsin Medical Journal says remains a persistent racial disparity: African American women in the state, although less likely than white women to develop breast cancer, are still more likely to die from it. Explaining why has proven difficult despite “decades of research,” the study says.

Between 2002 and 2006, 109 out of every 100,000 black women in Wisconsin were diagnosed with breast cancer – a rate about 15 percent lower than that for white women. For them, the rate of diagnosis was 124 out of every 100,000 women.

But for black women, mortality was higher, and not just for those who had contracted the disease. It was higher for all black women: In the same time period, 26 out of every 100,000 black women died from breast cancer, compared to 23 out of every 100,000 white women.

The study, authored by researchers from the UW-Madison Carbone Cancer Center, compared these statistics to those from about a decade earlier (1995-1997) and found that although breast cancer rates for both black and white women in the state had declined since then, the racial gaps had not changed. In fact, they had remained almost identical.

The higher death rate for black women who contract cancer remains the most troubling racial gap. The Minority Nurse magazine has called it “one of the most puzzling of all minority health disparities.”

“It has persisted,” says oncologist Lisa LePeak, the study’s lead author, “and that means we’ve not really addressed the reason for the difference.”

Finding that reason – LePeak says it’s likely a combination of them – hasn’t been easy. The problem is a national one. In fact, the breast cancer mortality rate for black women in the U.S. is slightly higher than in Wisconsin.

According to the U.S. Centers for Disease Control and Prevention, “Studies suggest that this disparity is due to African American women being diagnosed with breast cancer at a later stage and receiving treatment later after diagnosis.”

In Wisconsin, between 1995 and 2006, black women were significantly more likely to be diagnosed with late-stage breast cancer than white women. Although access to screening is an issue, LePeak says, it doesn’t fully explain why black women are more likely to die from breast cancer. Research comparing black and white women with equally advanced cases of cancer has found that the black women are still more likely to die from it.

The National Cancer Institute (part of the National Institutes of Health) blames the disparity on a “lack of medical coverage, barriers to early detection and screening and unequal access to improvements in cancer treatment.”

But that’s still not the whole story, according to LePeak. The tumors of black women may actually function differently on a biological level.

Some studies, the report says, have shown that “African American women are at greater risk for early onset of breast cancer and are often diagnosed with biologically more aggressive forms.”

Also, the tumors of black women may not respond as well to new medications – drugs that were developed in clinical trials with few African American participants. And clinical trials don’t typically report their results based on race, meaning it’s difficult to later evaluate a drug’s effectiveness in treating breast cancer in black women.

Research is expected to continue; LePeak says there’s been an explosion in studies examining minority cancer disparities in recent years.

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