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- Triggering Signals of BRCA1 Breast Cancer (K Kessenbrock)
- Testing Diverse Groups Finds New Breast Cancer Genes (L Teras)
- Black Women & Genetic Testing (J Palmer)
- Women 65+ & Genetic Tests for Breast Cancer Risk (L Teras)
- High-Risk Genes and Screening (A Patel)
- New Risk Calculation May Affect Breast Cancer Screening (L Teras)
- Black Men and Breast Cancer (H Sung)
- Platelets May Help Breast Cancer Spread (E Battinelli)
- Natural Killer Cells & TNBC (R. Chakrabarti)
- Improving Chemotherapy (O Sahin)
- Combo Treatment for TNBC (K Varley)
- Treatments Attack Cell Division (A Holland)
- ER+ Treatment in Mice (P Kenny)
- Blood DNA Monitors Metastasis Treatment (H P Ji)
- PTK6 Gene as Treatment Target (H Irie)
- Time-Lapse Cell Movies (S Spencer)
- 3D Mini Breast Tumors May Help ID New Cancer Treatments
- AI Tool Improves Breast Cancer Prognosis Accuracy
- Exercise & Sitting Time (E. Rees-Punia)
- Cancer Risk Factors in LGBTQ Populations (B. Charlton)
- CPS-3 Disparities Studies
- Cancer Disparities in the US (F. Islami)
- Housing Assistance and Mammograms (H Lee)
- Clinical Trial Treatment Cost App (L Hamel)
- Podcasts, TheoryLab
- Patients Health Insurance Tool (M. Politi)
- Breast Cancer Treatment in Ethiopia (A. Jemal)
- Better Survival Requires Better Insurance (J Zhao)
- Medicaid Eligibility Limits (J Zhao)
- New Treatment for Neuroblastoma (A Heczey)
- Oncogenic Fusions AML (S Meshinchi)
- Genetic Risks (L Teras)
- New Medulloblastoma Drugs (J Rodriguez-Blanco)
- Potential New Hope for MLL (J Grembecka)
- Increase in Brain Tumor Diagnosis (K Miller)
- Longer Life Expectancy for Survivors (J Yeh)
- Potential Target for New Osteosarcoma Drugs (C Benavente)
- At-Home Chemo for Children with HR ALL (L Ranney)
- Childhood Cancer Research Landscape Report
- Tumor-Infiltrating Neutrophils (R. Sumagin)
- New Epigenetic Target (K Rai)
- Extra Chromosomes (Aneuploidy) Effect on Cancer (J. Sheltzer)
- Discovery of a New Biomarker Is the First Step to New Treatment (C. Maher)
- Designer Virus Targets and Kills CRC Cells in Mice (S. Warner)
- Tiny Sensor in Mice May Find Cancer That's Trying to Spread (L. Hao)
- Targeting a Protein “Turned on” by Mistake (N. Gao)
- Spatial Map Intestines (J Hickey)
- CRC Treatment Podcasts
- Keto Molecule & Colorectal Cancer (M Levy)
- Availability of Healthy Food (L Tussing-Humphreys)
- 45 Min/Day of Physical Activity (A Minihan)
- Fewer than 10K Steps/Day (A Patel)
- Yogurt & Cheese & ER- Breast Cancer (M McCullough)
- Stage 2 Clinical Trials for New Endometrial Cancer Drug (V Bae-Jump)
- Hard-to-Starve Pancreatic Cancer Cells (N Kalaany)
- Coffee Risks for Colorectal Cancer (C Um)
- Food Parasite & Brain Cancer Risk (J Hodge)
- Exercise & Quality of Life in Older Survivors (E Rees-Punia)
- 21 Metabolites Linked with Breast Cancer (Y Wang)
- Replacing Sitting May Affect Weight (E Rees-Punia)
- CPS-3 Researchers Ask What People Eat and Check Urine Samples (Y Wang)
- Video Games Motivate Exercise? (E. Lyons)
- Food Choices and Colon Cancer Risk (P. Chandler)
- Race, Exercise & Breast Cancer (C. Dallal)
- Diet with Colorectal Cancer (M. Guinter)
- Biomarkers May Improve Prediction (Y Wang)
- Kickstart NSCLCs Clinical Trials (L. Eichner)
- Mapping Mitochondria's “Dance” (D. Shackleford)
- E-Cig Use Ages 18 to 29 (P. Bandi)
- Stopping Smoking Earlier in Life (F Islami)
- Most with Lung Cancer Smoked (A Jemal)
- Furthering Lung Cancer Screening & Equity (S Fedewa)
- Mouse Lung Organoids for Research (C Kim)
- Quality of Life for Lung Cancer Survivors (J Temel)
- Precision Therapies for NSCLC (P Jänne)
- Cancer Deaths from Smoking (F Islami)
- Lung Cancer Surgery Disparities (A Jemal)
- BRG1-Deficient Lung Cancers (C Kim)
- Yoga for Couples with Lung Cancer (K Milbury)
- Metabolic Differences as New Drug Targets (A Marcus)
- CPS-II & CPS-3 Inform About Risks of Ovarian Cancer
- Machine Learning & Glowing Nanosensors (D Heller)
- Ovarian Cancer May Start in Fallopian Tube Cells (K Lawrenson)
- New Gene Linked with Deadliest Type (C Han)
- Gene-Testing Tools May Personalize Care (A Sood)
- Chromosome-Hoarding Ovarian Cancer Cells & Treatment (J Sheltzer)
- Nanoparticles as Drug Delivery for Metastases (X Lu)
- Turning Off 2 Proteins to Slow HGSC (P Kreeger)
- Targeted Light Therapy in Mice (M Bai)
- Nanoparticles, CAR T, and CRISPR (M Stephan)
- Endometriosis & Ovarian Cancer in Mice (M Wilson)
- Ovarian Cancer Special Section
- UV Exposure, Melanoma, & Dark Skin Types (A. Adamson)
- Melanoma and Lipid Droplets (R. White)
- Zebrafish and Acral Melanoma (R. White)
- T-Cell Lymphoma and PD1 (J. Choi)
- New Drug Destroys Cancer-Causing Protein (C. Crews)
- Virus & Merkel Cell Skin Cancer (R. Wang)
- Non-Genetic Drug Resistance (S. Spencer)
- Hijacking the Body's Sugar (R. Wang)
- Telling about High Risk (P. Kanetsky)
- Brain Metastasis and Alzheimer’s (E. Hernando)
- Exhausted Melanoma "Killer" Cells (W. Cui)
Community Health Centers Meet Only 50% of Mammography Needs
ACS recommends targeted solutions for community health centers to reduce screening disparities based on race and health insurance coverage.
The Challenge
Mammography screening can reduce breast cancer mortality by allowing women to be diagnosed earlier, when the cancer can usually be successfully treated. Yet in the United States, screening disparities based on race and income levels leaves many women at risk for not getting diagnosed until the breast cancer is at a later stage, when treatment options are usually limited and the chance of survival is typically poor. Some of these disparities are a holdover effect of redlining (see blue box below).
Community Health Centers (CHCs) play an important role in providing cancer prevention and screening services by primarily serving people with low incomes who are vulnerable to barriers to accessing health care. In 2020, breast cancer screening was added as a quality-of-care metric to the Uniform Data System, which tracks performance of CHCs.
The Research
American Cancer Society (ACS) Associate Scientist, Jessica Star, MA, MPH, led the evaluation of this first year of available CHC breast screening data. She worked with several ACS colleagues: Priti Bandi, PhD, Adair Minihan, MPH, Ahmedin Jemal, DVM, PhD, and former ACS scientist Stacey Fedewa, MPH. They published their results in Preventive Medicine.
It is necessary for all health centers to address racial disparities in care and to atone for the decades of medical and public health mistreatment of Black persons, including the consequences of historical redlining. We have a responsibility as medical and public health professionals to reckon with systemic racism, and our own privileges, when developing health promotion and intervention activities.”
Jessica Star, MA, MPH
Surveillance & Health Equity Science
American Cancer Society
The team reviewed data from more than 1000 community health centers across the nation. They found that:
- Less than half of women (43.6%) who were eligible for breast cancer screening were up to date with screening guidelines. This is lower than the national average for mammography in women with incomes below the Federal Poverty Level.
- CHCs with medium or high proportions of Black people and people without health insurance had between 9% to 14% lower breast cancer screening rates than CHCs with low proportions of these populations
- CHCs in Medicaid expansion states and in Northeastern states had significantly higher screening rates than non-expansion states and the Midwest, South, and Western states.
Why It Matters
The authors conclude, “Targeted solutions centered around reducing cost, improving quality, and reducing structural disparities are needed to address low rates of breast cancer screening” in people with low incomes who use CHCs, who are likely to already experience healthcare inequities. They add, “It is important that we frame any future interventions while considering the history of medical and geographic discrimination against Black women.”
Redlining: The Basics
From the 1930s through the 1960s, residents in more than 200 cities across the United States were denied home loans based on their race or ethnicity. This deliberately discriminatory practice was called redlining, and it was based on the Home Owners’ Loan Corporation's (HOLC, a federal government agency) use of racist, color-coded maps to rank the loan worthiness of neighborhoods. The maps outlined areas where Black residents lived in red, deeming them risky.
Redlining prevented people of all races who lived in those neighborhoods from receiving home loans, but the largest impact was on Black families. The practice reinforced segregation, which already existed in the US. What’s more is that redlining cut specific neighborhoods within cities off from investments in health care, education, and other services.
Discriminatory home lending practices remain.
Redlining became illegal in 1968, but redlining practices in home lending remain. In the US, homeownership is the principal means of building wealth, and families of color have persistently lagged in home-ownership rates. In fact, the gap between Blacks and Whites in home ownership is larger today than it was in 1960. Plus, homes in formerly redlined districts are chronically undervalued.
Effects of redlining persist.
Studies show that people who live in formerly redlined areas are more likely to be exposed to environmental hazards, such as air pollution and extreme heat waves. They also have a higher risk of developing health issues, including cancer.
People in these areas also have a higher risk of limited access to health care, which often leads to delays in diagnosis and treatment—and that can result in worse outcomes.