Widening Survival Disparities in Breast Cancer: The Impact of Race and Health Insurance
Recent findings from a study led by the American Cancer Society (ACS) reveal significant inequalities in survival rates from breast cancer based on race and health insurance status in the United States. Presented at the 2025 American Society of Clinical Oncology (ASCO) Quality Care Symposium, this research underscores the urgent need for policy reforms to bridge this gap.
Key Findings on Survival Disparities
Survival Rates Among Women Diagnosed with Breast Cancer
The study specifically looked at women aged 18 to 64 who were diagnosed with breast cancer between 2004 and 2023, using data from the National Cancer Database (NCDB). The results showed alarming trends:
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White Women with Private Insurance: Serving as the baseline group, they demonstrated the best survival outcomes.
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Non-Hispanic Black Women: Those with private insurance had a hazard ratio (HR) for survival of 1.93 (95% CI, 1.83-2.05) compared to their White counterparts, indicating a growing disparity since 2014 when the HR was 1.79 (95% CI, 1.72-1.86).
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Women with Medicaid and Uninsured: Among women diagnosed from 2019 to 2023:
- Non-Hispanic Black women with Medicaid had an HR of 4.49 (95% CI, 4.20-4.81).
- Uninsured non-Hispanic Black women faced an even graver HR of 6.90 (95% CI, 6.03-7.89).
These figures reflect a noticeable increase from the earlier period of 2014 to 2018, where the respective HRs were 3.63 (Medicaid) and 6.43 (uninsured).
The Impact of Age and Comorbidities
Interestingly, a larger percentage of Black patients are diagnosed with breast cancer under the age of 50 compared to their White counterparts. Recent statistics show:
- Under Age 50 Diagnoses:
- White Women:
- Private Insurance: 36.3%
- Medicaid: 41.9%
- Uninsured: 37.7%
- Non-Hispanic Black Women:
- Private Insurance: 42.1%
- Medicaid: 47.6%
- Uninsured: 42.9%
- White Women:
Additionally, Black women were found to have a higher incidence of multiple comorbidities compared to White women, a factor that further complicates treatment and survival outcomes.
The Implications of the Findings
Dr. Jingxuan Zhao, a researcher at the ACS, emphasized, “Survival disparities by health insurance and race among women newly diagnosed with breast cancer widened over time, especially in recent years.” The data suggests that financial barriers to accessing quality care and treatment continue to hinder progress in equitable health outcomes.
Recommendations for Future Policy
The findings call for urgent action in the form of enhanced health insurance coverage and financial assistance programs. Implementing policies aimed at improving access to care for low-income and uninsured patients could significantly ameliorate these disparities in survival rates.
Conclusion
As the study reveals, survival disparities in breast cancer remain a critical issue, particularly among marginalized racial groups and those lacking health insurance. Addressing these gaps through effective policy changes is essential to ensuring that all women, regardless of their race or financial status, have equitable access to life-saving treatments.
References
- Zhao J, Chino F, Han X, Nogueira L, Zheng Z, Yabroff R. Trends in survival disparity following breast cancer diagnosis by health insurance coverage and race in the US. JCO Oncology Practice. 2025;21(suppl 10):218. doi:10.1200/OP.2025.21.10_suppl.218.
This article not only highlights the stark contrasts in breast cancer survival rates but also serves as a clarion call for collective intervention to foster health equity. By raising awareness and advocating for policy change, we can hope for a future where survival is not determined by race or insurance status.