Ethnic Differences in Breast Cancer Survival: Status and Determinants

Ethnic differences in breast cancer survival have been a long-standing concern. The objective of this article is to present relevant studies for all major US racial/ethnic groups including African–Americans, Latinos, Native Americans, Japanese–Americans and Native Hawaiians, and to discuss underlying causes of disparity, In comparison to Caucasian women, African–American women continue to experience the poorest breast cancer–specific survival of all ethnic groups in the USA. The prognosis for Latinos, Native Hawaiians and Native Americans is intermediate, better than for African–Americans but not as good as for Caucasians, whereas Japanese–American women tend to have better outcomes. The following possible contributors to the observed differences are discussed in detail: unfavorable distribution of stage at diagnosis due to low screening rates, limited access to care and treatment, tumor type, comorbidities, socioeconomic status, obesity and physical activity.