Breast cancer and the social inequalities affecting health

Social inequalities of health play out in breast cancer as with other major illnesses. The Canadian Partnership Against Cancer's 2016 Cancer System Performance Report shows that the five year net survival rates for breast cancer are highest in high income populations and lower-income populations have lower survival rates. Furthermore, there is evidence in the scientific literature that lower-income patients are less likely to have their symptoms recognized and investigated early, resulting in a more advanced diagnosis, when treatment is less effective, and ultimately, in a poorer prognosis.[1].

In addition, the Public Health Directorate of Montreal has identified breast cancer as an important example of the impact of social inequality affecting health because poorer women tend to have slightly lower rates of diagnosis of the disease, but higher rates of mortality[2].

The overall trend of breast cancer incidence (how many women are diagnosed with the disease) is relatively stable. But within that trend, different populations of women experience very different rates of incidence (getting the disease) and mortality (dying from the disease). Some populations of women, for example certain women who are recent immigrants, have incidence rates of breast cancer that have risen significantly; other populations of women, particularly Black women, have disproportionately high mortality rates. We need to better understand these trends, learn from them, and inform women who may need specific information about their health and screening.

 

[1] Canadian Partnership Against Cancer (2016). The 2016 Cancer System Performance Report. Toronto (ON): Canadian Partnership Against Cancer; July. 128p.

[2].Agence de la santé et des services sociaux de Montréal (2011). Rapport du Directeur de santé publique 2011 : Les inégalités sociales de santé à Montréal. Montréal, Direction de la santé publique. pp. 80-82.