Racial disparities among breast cancer cases Edgecombe County appears to be less profound than in 2007 when a seminal report on breast cancer was issued, but while some positive change has been seen in ongoing local efforts to improve breast cancer knowledge and care, other efforts have still fallen short.

Those are the findings of a new study lead by a researcher from the University of North Carolina at Chapel Hill’s Gillings School of Global Public Health. The study focused on Nash, Orange and Edgecombe counties, the latter of which was identified as having among the highest national incidences per capita of breast cancer incidence and mortality rates by a 2007 Susan G. Komen organization study. The researchers found that since the 2007 study, Edgecombe’s breast cancer incidence rate of 185.3/100,000 experienced a 16 percent decline. The declines in the two comparison counties were much less dramatic.

While also rural and bordering Edgecombe county, Nash County has fewer African Americans (37.2 percent) than Edgecombe County (55.9 percent) and Orange County is more affluent than both and has more ready access to health care. These factors informed using the two counties for comparison with Edgecombe. The researchers believed the contrasts would offer insights into potential disparities in access to breast cancer information and care. Overall the results were somewhat encouraging.

“It may have been that the 2007 study marked a highpoint in breast cancer incidents, sounded an alarm or both, but whatever the case, we’ve seen a marked decline since then,” said Anissa I. Vines, PhD, assistant professor of epidemiology at UNC’s Gillings School and the study’s lead author. “There definitely was an increase in efforts to get information out about breast cancer diagnosis and treatment, especially among the African American community in the time since that report was issued. It wasn’t just one person or one organization, but multiple organizations with a shared desire to address the concerning breast cancer rates in Edgecombe county. All the people from organizations in the community were willing to work together, leverage the support of each other and really tackle this situation.”

However, Vines is quick to add that more work needs to be done, and the data back this up. Women in Edgecombe and Nash counties were still more likely to be diagnosed with advance stage breast cancer than women in Orange County. African American women in Edgecombe and Nash counties were diagnosed with advanced stage cancer more often than African American women in Orange County, as well.

Vines says, that, as is the case in most rural counties, and for African American women specifically, improving early access to information, diagnosis and care are essential to continue any improvements.

“Ongoing surveillance of breast cancer outcomes and the influx of scientific advances from breast cancer research to the community will also be critical to supporting local efforts,” Vines said. “Likewise, resources to support community grassroots efforts and community-academic research partnerships are also necessary.”

The study, titled “Responding to a Community’s Concern: A Comparison of Breast Cancer Characteristics and Initial Treatment in Three Selected North Carolina Counties,” appeared in the recent issue of the North Carolina Medical Journal. Study co-authors included William R. Carpenter, PhD, adjunct associate professor of health policy and management at the UNC Gillings School and a member of the UNC Lineberger Comprehensive Cancer Center and Ronald C. Chen, MD, MPH, associate professor of radiation oncology, member UNC Lineberger Cancer Center and senior fellow at UNC’s Cecil B. Sheps Center for Health Services Research.

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