Laurén A Doamekpor PhD, MPH and Diana Zuckerman PhD, Cancer Prevention & Treatment Fund
The disparity in breast cancer mortality between Black and White women has widened in our country’s most populated states. Cancer experts usually conclude that although there have been advances in breast cancer screening, prevention and treatment, these advances have not been equally available to Black and White patients.
Most experts fail to mention that there is a fundamental problem that could explain this disparity: lack of research on the kinds of treatment that are most effective for Black women with breast cancer. Dr. Laurén Doamekpor and Dr. Diana Zuckerman of the National Center for Health Research published a short article in Cancer Epidemiology that agreed that although access is a problem, a lack of racial and ethnic diversity in clinical trials exacerbates this disparity.
Clinical trials have provided essential information on the treatments and prevention strategies that work best, but those studies have focused on White women. Patients of color are very underrepresented in clinical trials that are submitted to the Food and Drug Administration (FDA) when a company applies for FDA approval. Since relatively few people of color are included in studies submitted to the FDA, and even fewer studies analyze and report safety and efficacy separately by race or ethnicity, scientists have not discovered treatments that are safe and effective for minority patients if those patients metabolize certain drugs differently or tend to have different types of cancer, such as the “triple negative breast cancer” that is more common among Black women than White women. This contributes to racial disparities when treatments are not adequately tested for safety or efficacy in these populations.
All articles are reviewed and approved by Dr. Diana Zuckerman and other senior staff.
- Hunt BR, Whitman S, Hurlbert MS. Increasing Black:White disparities in breast
cancer mortality in the 50 largest cities in the United States. Cancer Epidemiol
- Doamekpor LA, Zuckerman DM. Lack of diversity in cancer drug clinical trials may exacerbate racial disparities in mortality rates. Cancer Epidemiol
- Food and Drug Administration. FDA Report: Collection, Analysis, and Availability of Demographic Subgroup Data for FDA-Approved Medical Products, August 2013; 2014, Available at: http://www.fda.gov/downloads/RegulatoryInformation/Legislation/FederalFoodDrugandCosmeticActFDCAct/SignificantAmendmentstotheFDCAct/FDASIA/UCM365544.pdf (accessed 31.03.14)