Memphis reducing racial disparity in breast cancer deaths
Tom Charlier
Even though she's a living testament to the importance of regular mammograms, Polly Edwards says she knows why many of her fellow African-Americans fail to get tested for breast cancer.
"I think a lot of it is lack of knowledge -- not realizing the importance of early detection," said the 64-year-old Bartlett resident, who also cited lack of access to care and a fear of medical procedures as reasons.
Edwards, who grew up in Frayser, underwent surgery, chemotherapy and radiation in 2010 after a mammogram detected a cancerous lump. She is now cancer-free.
In addition to being a survivor, Edwards is a symbol of progress in reducing the racial disparity in cancer death rates in the Memphis area.
Memphis mortality gap narrows
In a study that received national publicity three years ago, Memphis was identified as having by far the greatest disparity in breast cancer-mortality rates between black and white women of any of the 50 largest U.S. cities from 2005 through 2009.
Locally, black women during that five-year period died from the disease at a rate of 44.3 per 100,000 females -- more than double the rate of 21 per 100,000 for white women. Los Angeles was a distant second in racial disparity, with African-American women dying at a rate 70 percent higher than Caucasians.
But new figures -- conducted by researchers for the Sinai Urban Health Institute in Chicago and the New York-based Breast Cancer Research Foundation -- indicate Memphis has narrowed the gap significantly and dropped to seventh on the list of cities with the greatest disparities.
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Memphis was one of just three cities, in fact, that showed a significant decrease in disparity, according to the study, which was released last year by the Avon Foundation for Women.
During the period of 2010-2014, the breast cancer mortality rate for black women in the city fell to 37.5 per 100,000, which was 68.9 percent higher than the rate of 22.2 for white women. The local improvement occurred even as the disparity in death rates widened nationally.
Medical professionals and health-care groups say the reduction in Memphis' disparity in mortality rates was no accident. In the aftermath of a 2014 New York Times report on the disparity study, they launched a series of initiatives aimed at raising awareness and making it easier for black women to get mammograms and receive treatment.
"We really took that on as a cause celebre, because that (high disparity) was really unacceptable," said Dr. Kurt Tauer, a medical oncologist and chief of staff at West Cancer Center.
A coordinated effort: 'We have moved the needle'
Groups such as Susan G. Komen and the Avon Foundation, along with Genentech Inc., a San Francisco-based firm that develops cancer treatments, began funding mammograms for poor women. A public awareness campaign known as Sister Pact, promoted at local churches, was launched to help black women encourage each other to get tested.
Local hospitals sent mammogram buses into the community to make the testing more accessible. At West Cancer Center, the number of mammograms conducted on uninsured women has grown from a couple dozen to some 2,000 annually, Tauer said.
And, in 2015, more than two dozen groups that included health-care providers, insurance companies and non-profit organizations worked with the Common Table Health Alliance to form the Memphis Breast Cancer Consortium. It provides for a consolidated effort to reduce the mortality-rate disparity.
"There is no other group going (nationally) like what we have in Memphis," consortium project director Carla Baker said during a pause between sessions at the recent Living Beyond Breast Cancer conference held in Memphis.
"We have moved the needle."
Promoting early detection
The main emphasis of the group, Baker said, is early detection, the key to surviving breast cancer. Patients diagnosed with Stage 1 cancers, which involve small tumors that have not spread, generally have five-year survival rates of 90 percent or more. However, those whose disease is detected at Stage 4, when cancer has spread throughout the body, usually face a grave prognosis.
One of the primary obstacles to early detection is the paucity of mammogram facilities in low-income communities, Baker said. She points to a map showing that some of the Zip Codes with the highest breast cancer death rates -- including those encompassing Frayser and Southwest Memphis -- have no mammogram facilities.
But it's more than lack of access that prevents African-Americans from getting tested and treated, said Dr. Alyssa Throckmorton, a breast surgeon and medical director for the multidisciplinary breast oncology program at Baptist Cancer Center. Many retain a distrust of the medical establishment stemming from the infamous Tuskegee Study, in which black men were subjected to untreated syphilis from the 1930s into the 1970s, she said.
Another factor, Throckmorton said, is a lack of awareness that early detection leads not only to better outcomes but "potentially less treatment, not more."
The strains of poverty also make it difficult for many black women to get tested. "I've had patients who were caring for other family members and neglecting their own health," Throckmorton said.
But obstacles to testing were just part of the problem, Tauer said. Poor women whose mammograms detected problems still had to gain access to treatment.
"The problem was, once they had a problem on their mammograms, they had nowhere to go," he said.
To alleviate that problem, the West center has been providing treatment to women whose mammograms detected cancer "regardless of their ability to pay," Tauer said.
Not a death sentence
Breast cancer remains the second-leading cause of cancer mortality among women, causing some 40,000 deaths annually in the U.S. White women are slightly more likely to contract it than African-Americans, but black women are more prone to getting the aggressive type called triple-negative breast cancer, which often strikes at a relatively young age.
Edwards, who works with a cancer-awareness group known as Sisters Network Memphis, said she hopes her successful battle with cancer will inspire hope. Many African-Americans associate the word 'cancer' with certain death, she said.
"I've heard people state that they would rather not know. They don't want to hear the word," Edwards said.
She wants others to know her experience proves the disease is beatable. "I had cancer, and I'm here, I'm cancer-free," Edwards said.
Reach Tom Charlier at thomas.charlier@commercialappeal.com or 901-529-2572 and on Twitter at @thomasrcharlier.