In a New York Times op-ed published this morning, Angelina Jolie wrote that she had undergone a double mastectomy as a preventative measure against breast cancer. Her decision came after she learned that she carries a mutated version of the gene BRCA1, which put her at an abnormally high risk of developing breast cancer. It has turned a spotlight on the question of what steps women can take to detect and treat the disease.
Among Latinas in the United States, breast cancer is the leading cause of cancer death. Though they are less likely than white women to be diagnosed with breast cancer, they are also less likely to have mammograms performed. Their survival rate upon diagnosis is 5 percent lower, largely because they tend to be diagnosed farther along in the cancer's progression, according to the American Cancer Society.
Studies have repeatedly shown that cancers of all kinds place an unequal burden on women of lower socio-economic status, especially if they are ethnic minorities. Researchers point to factors including lack of access and adequately utilization of medical resources, late diagnoses and delays in treatment.
A recent study from a University of Texas team found that in six U.S. cities, Latinas were diagnosed with breast cancer an average of 60 days after an abnormal mammogram, over twice as long as white women.
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According to Larisa Caicedo, executive director of Nueva Vida, an organization which provides early detection treatment and survivorship care for Latinas with cancer, significant disparities in breast cancer care between Latinas and other ethnic groups are often found among a specific piece of the Latina demographic: women who are undocumented, uninsured and low-income, with limited education and often no understanding of how to navigate healthcare systems in the United States.
"20 percent of Latinas [with breast cancer] are more likely to die than their white counterparts," Caicedo told the Latin Times. She pointed to lack of insurance as a major factor -- more than 32 percent of the nation's uninsured are Latinos -- which exacerbates problems like linguistic barriers and cost of care.
"If you're uninsured, where do you go find services that may cost you $10,000 and above? For a biopsy you can pay $5,000 to $10,000 and a mammography can cost $400 to $800. And what's going to happen next? They don't have that kind of money," said Caicedo, adding that cultural factors sometimes play a role as well. "We don't have preventative medicine as part of the culture, so we wait until something is wrong and then we go. By the time we go, a tumor might be bigger than we can control."
Caicedo took pains to emphasize that Angelina Jolie's procedure could not be considered a preventative one for the large majority of people. "People who have the BRCA1 gene are 5 percent of the breast cancer population," she said.
The National Breast Cancer Coalition recently announced it would launch an initiative to end breast cancer by 2020.
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