By Ricki Fairley
TOUCH the Black
Breast Cancer Alliance
The oncology community welcomed President Biden’s announcement earlier this year to reignite the Cancer Moonshot initiative and the past few months have been filled with excitement and hope.
The Administration’s Cancer Moonshot goals are to:
• Over the next 25 years, cut today’s age-adjusted death rate from cancer by at least 50 percent
• Improve the experience of people and their families living with and surviving cancer
Additionally, Cancer Moonshot is also focused on enhancing prevention, addressing inequities, supporting patients, survivors, and caregivers and learning from people living with cancer. If successful, Cancer Moonshot has the potential to essentially create a paradigm shift in cancer care which would dramatically affect clinicians and patients.
While this national endeavor focused on cancer is extremely important, the circumstances surrounding Black Breast Cancer need to change now. Too many young, vibrant mothers, daughters and friends are dying every day. Black women don’t have 25 years to wait.
As a 10-year survivor of Triple Negative Breast Cancer (TNBC), which is very aggressive and disproportionately affects Black, Hispanic and younger women, I have made it my mission to eradicate Black Breast Cancer. Earlier this year I participated in a Cancer Moonshot panel discussion as part of the National Minority Quality Forum’s Summit on Health Disparities.
While Black breast cancer was not the main topic of the forum, I seized the opportunity to share some staggering statistics about the inequities in this area – particularly regarding Triple Negative Breast Cancer (TNBC). Black women are diagnosed with de novo metastatic breast cancer at a 58% higher rate than White women.1 Black women with breast cancer have a 71% higher relative risk of death compared to White women.2 Black women are 41% more likely to die of breast cancer than White women.3
The data surrounding triple negative breast cancer (TNBC) further exemplifies the disproportionate impact on Black women. Black women have a 3 times higher odds of being diagnosed with TNBC.4 Black women are at a 38% increased risk of being diagnosed with stage IV TNBC than White women5. Black women have the lowest survival rate at each stage of diagnosis6 and are 28% more likely to die from TNBC than White women6.
There is an immediate need to address the significant impact of breast cancer on Black women and a particular focus must be on increasing awareness and understanding about TNBC. Cancer Moonshot’s aims of creating a paradigm shift in the oncology field must be applied to Black breast cancer and happen sooner vs. later.
Recent research has shown that breast cancer in Black women does not present the same as it does in White women. Black women are at increased risk, are often younger when affected by breast cancer, and respond differently to treatments. A new standard of care specifically based upon the physiological differences of Black Breast Cancer must be developed and adopted.
Additionally, we must improve diversity of clinical trials and continue to advance science. All women with breast cancer, but especially Black women, need more treatment options. Clinical trial participation by Black women must be commensurate with the burden of disease. New treatments aimed at addressing specific clinical issues surrounding Black Breast Cancer require greater participation by Black women in clinical trials.
While this intense national focus on cancer provides a unique opportunity to elevate the unique issues and significant inequities surrounding Black breast cancer, only time will tell if the Cancer Moonshot initiative can be sustainable and impactful. While many members of the oncology community have already engaged in Cancer Moonshot efforts and pledged their future support, achieving the long-term goals of this national initiative to change the cancer care paradigm will depend heavily on its leadership.
If we reflect on our national’s COVID experience, the importance of a strong and respected public facing leaders who can unify many different entities behind a common goal cannot be underestimated. Collaboration among researchers, clinicians, patients, advocacy organizations, medical and pharmaceutical companies, and insurers is necessary for success.
Furthermore, the leadership of Cancer Moonshot should routinely communicate to those in the oncology community and the general public to document progress and encourage continued participation and support from the many diverse stakeholders.
Additionally, for current efforts to generate momentum that actually accrues toward achieving Cancer Moonshot’s long-term goals, the leadership needs to be sustainable and transition to a government cancer specialist who can withstand the political shifts which occur so frequently in our country.
5 Lu Chen and Christopher I. Li, Racial Disparities in Breast Cancer Diagnosis and Treatment by Hormone Receptor and HER2 Status, Cancer Epidemiol Biomarkers Prev November 1 2015 (24) (11) 1666-1672; DOI: 10.1158/1055-9965.EPI-15-0293