Racial Bias in the Treatment Decision of Breast Cancer in African American and Caucasian Women

Breast cancer stands as a formidable health challenge in the United States, ranking as the most prevalent and deadly diagnosed cancer and the second leading cause of cancer-related death among women. Of particular concern is the disproportionate impact on African American women, who experience elevated mortality rates compared to other demographic groups. This quantitative study, grounded in critical race theory, investigated whether there is an association between race as well as comorbidity score and first-course treatment plans for breast cancer among women in the State of Georgia, United States, adjusting for the stage of breast cancer, age, and household income. Utilizing data from the National Cancer Database for 2016, the study employed multinomial logistic regression for analysis. The adjusted ratio for Caucasian women receiving the "surgery & hormone therapy" treatment plan revealed a substantial association (AOR = 0.31, 95% CI: 0.09 - 0.96, p = 0.040). However, for the "surgery, radiation, & hormone therapy" treatment plan, there was no statistically significant association between race and the specified treatment plan (AOR = 0.63, 95% CI: 0.26 - 1.54, p = 0.311). Furthermore, for the "surgery & hormone therapy" treatment plan, the study found no statistically significant association between high comorbidity scores and first-course treatment plan (AOR = 0.44, 95% CI: 0.06 - 3.40, p = 0.422). Similarly, for the "surgery, radiation, & hormone therapy" treatment plan, there was no significant association between high comorbidity score and first-course treatment plan (AOR = 2.04, 95% CI: 0.74 - 5.64, p = 0.422). In advocating for a lowered recommended age of at least 40 years for initiating breast cancer screening in African American women, this study may enhance early diagnosis, improve survival rates, and expedite referrals to oncologists.