Why the New Breast Cancer Guidelines Are Racist


Some might think the word racist is overused and too harsh for the new breast cancer guidelines, issued by the U.S. Preventive Services Task Force. The fact is, though, the new rules that call for raising the recommended age for women to begin getting mammograms from 40 to 50 ignore the thousands of Black women who die from the disease each year. Black women, in fact, are typically diagnosed with cancer at a younger age than white women, and at a more advanced stage of the disease. The appropriate protocol for women of color would be to receive mammograms earlier not later. 

When you entirely dismiss a segment of the population, and that population happens to be a racial minority — one that is at a greater risk of dying from breast cancer than any other population — what do you call it? It might not be overt racism, but these new guidelines are the very definition of institutionalized racial discrimination.

Here are some facts to consider, courtesy of Sisters Network, the Black Women's Health Imperative and the American Cancer Society:

  • An estimated 19,540 Black women will be diagnosed with breast cancer this year, and more than 6,000 will die.
  • Black women are 53 percent more likely than white women to be diagnosed at a later stage in the disease, and about 26 percent are less likely to receive radiation after breast-conserving surgery.
  • Black women are more than twice as likely to receive no surgery at all and 39 percent more likely to die from breast cancer.

And the worst of it is the government appears to be making the change in order to appease or shore up the bottom line of the insurance industry.

The new guidelines

As we know, Black women are often diagnosed at an earlier age, but in a more advanced stage of breast cancer. Just as the federal agency announced it would make the change, many health education advocates for racial minorities were beginning to campaign to lower the age from 40 to 35.

Health educators have said one of their biggest obstacles in educating Black women about breast cancer is that much of the existing prevention information is not inclusive enough of women of color — something that isn't likely to change with the new guidelines.

The move will be save a lot of money for the insurance industry, but those savings come at a huge cost for women in general, and especially women of color. These new recommendations will undoubtedly affect insurance coverage, and women under 50 will likely have to pay out of pocket for breast cancer exams, which will, of course, play a part in determining how many have them.

“We were all very surprised and taken aback,” said Karen E. Jackson, the founder and CEO of Sisters Network, a national, Texas-based nonprofit that provides education, services and support for women affected by the disease. “These guidelines are going to have a negative, crucial impact on our survival.”

In October, we marked Breast Cancer Awareness Month, and what was often missed in that sea of pink ribbons were Black mothers, sisters and daughters, even though we are 38 percent more likely to die of breast cancer than our white counterparts. Some of this disparity is explained by socioeconomic factors, insurance coverage and the fact that health care professionals sometimes communicate differently with people of color. But the prevailing wisdom is that Black women aren’t getting tested, and they are not getting tested early enough.

Sisters ignored, again

As the new guidelines hit the mainstream news media, not one major organzation seemed to notice how they would affect Black women. Criticism surfaced quickly, but the race factor was missing from the debate.

“Out of all that coverage, was there one Black woman spoken too? Minorities were not represented. We now know we must be on that (policy) side of the breast cancer issue too. Something like this just reignites the need for us to be involved on the policy side,” Jackson said, adding that her group focuses primarily on breast cancer among Black women because there are so few agencies out there doing it.

“I’m already diagnosed. This is not about me. This is about the next wave of women of color who are diagnosed. This is going to change how the next group of women are treated. This is going to affect how early they are diagnosed. This is going to affect how likely they are (to survive),” she said.

But it's not just Black women health care advocates are concerned about.

“I can’t speak to why they recommneded changing the guidelines. All I can say is that we won’t be changing ours,” said Andrea Barish, of the American Cancer Society’s Northern California office. “There are a lot of concerns about these changes. And the early detection rates for Black women are definitely one of them. But it’s about all women really. There are a lot of women who are being diagnosed with breast cancer before the age of 50.”

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