Recently, The New York Times published an article on the results of an extensive study of 90,000 women conducted over 25 years; according to that study, death rates from breast cancer and other causes were the same for women who had had mammograms and those who had not. In addition, the study found that one in five cancers identified through mammography and treated turned out to be non-threatening. This study gives new ammunition to the rising anti-mammogram movement, which claims that screenings do not help and in some cases do more harm than good. Cancer research in women remains a growing field, and grey areas such as the debate over chemotherapy still dominate the conversation. This issue in particular highlights an important factor in cancer research, particularly cancer research in women, that is overlooked: white women are still much better off when it comes to cancer than non-white women.
Critiquing mammograms is all well and good, but let’s face it: free clinics offering screenings remain some of the few, often only, resources that minority and low-income women have to information about cancer and potential diagnoses. It is true that with all of our progress, we are still not beating breast cancer, not to mention other cancers with even higher rates of mortality, such as ovarian cancer. Still, treatment options usually focus on white women who have health insurance and can afford treatments, which are often not covered by insurance companies.
In “Tackling a Racial Gap in Breast Cancer Survival,” Tara Parker-Pope writes, “Despite 20 years of pink ribbon awareness campaigns and numerous advances in medical treatment that have sharply improved survival rates for women with breast cancer in the United States, the vast majority of those gains have largely bypassed black women.”
According to research by the Sinai Institute, black women are 40 percent more likely than white women to die of their disease. They are not only more likely to die; they are also more likely to die sooner. According to womenshealth.gov, “African-American women are more likely than all other women to die from breast cancer. Their tumors often are found at a later, more advanced stage. So, there are fewer treatment options. Also, research has shown that African-American women are more likely to get a form of breast cancer that spreads more quickly.” These are stark facts that need to be addressed. Churches and community centers offer some of the best opportunities to spread information and advertise services, but that is a heavy burden in communities where churches do everything from offering medical clinics to helping shelter the homeless, and there is still an ongoing campaign by multiple organizations to persuade church and community leaders to even address the issue. Surely eliminating mammography, one of the few non-Church-offered resources offered, will inevitably increase mortality rates and undiagnosed cancers among minority women.
Health, especially in one’s sensitive areas, is incredibly personal, and different people approach illness and disease in different ways; this means that some of the most vulnerable groups of people at higher risk of certain cancers do not even know they are at risk and in turn are often not targeted by organizations. It’s a complex issue, of course, but mainstream cancer research organizations have yet to provide sufficient access to minorities communities, and in particular minority women.
African-Americans are not the only disadvantaged group when it comes to cancer and other illnesses. Trans* people, for example, still face significant hurdles when it comes to treatment and diagnosis of cancer and other serious diseases; many doctors are still slipping into unknown territory when it comes to approaching non-binary and trans* bodies and may overlook certain possibilities. Non-smokers who get lung cancer still remain one of the hardest groups in which to identify cancer before it’s progressed to an advanced stage. Skin cancer remains a hard area in which to spread information, because the perception is that only sun-sensitive skin types are at serious risk. In general, giving more people access to education and resources remains one of the most significant challenges in battling cancer.
I am not claiming that mammograms do not carry their own risks. Everything carries risk. One of the significant hurdles to widespread use of mammography is the discomfort from the process itself: it’s less painful and invasive than a trans-vaginal ultrasound, but not by much. In fact, though, mammograms are a tool that some women truly need; women for whom self-exams are more difficult to administer rely on mammograms as an essential part of their health management. Yes, it is possible that mammograms may cause a doctor to misdiagnose a lump or growth as cancer, but the alternative is that many more instances of cancer go undiagnosed. In this case, it is truly better to be safe than sorry, especially when it comes to aggressive cancers that require early detection in order for treatment to be effective.
In short, let’s keep using mammograms. There’s room for improvement, and we should work to improve the service, but we cannot afford to eliminate access to resources completely. Let’s not let mammograms go the way of vaccines; let’s not discourage people from using them out of fear. Let’s screen and educate as many people as possible, because when it comes to cancer, we all need all the help we can get, especially those of us who lack access when we may need it the most.