An overview of the unique challenges facing African-American breast cancer survivors

Support Care Cancer. 2019 Mar;27(3):729-743. doi: 10.1007/s00520-018-4545-y. Epub 2018 Nov 20.

Abstract

Purpose: The existence of cancer disparities is well known. Focus on alleviating such disparities centers on diagnosis, treatment, and mortality. This review surveyed current knowledge of health disparities that exist in the acute survivorship period (immediately following diagnosis and treatment) and their contributors, particularly for African-American breast cancer survivors (AA-BCS).

Methods: Utilizing the ASCO four components of survivorship care, we explore disparities in surveillance and effects of cancer and therapies that AA-BCS face within the acute survivorship period (the years immediately following diagnosis). A literature review of PUBMED, Scopus, and Cochrane databases was conducted to identify articles related to AA-BCS acute survivorship. The search yielded 97 articles. Of the 97 articles, 38 articles met inclusion criteria.

Results: AA-BCS experience disparate survivorship care, which negatively impacts quality of life and health outcomes. Challenges exist in surveillance, interventions for late effects (e.g., quality-of-life outcomes, cardiotoxicity, and cognitive changes), preventing recurrence with promotion of healthy living, and coordinating care among the healthcare team.

Conclusions: This overview identified current knowledge on the challenges in survivorship among AA-BCS. Barriers to optimal survivorship care inhibit progress in eliminating breast cancer disparities. Research addressing best practices for survivorship care is needed for this population. Implementation of culturally tailored care may reduce breast cancer disparities among AA-BCS.

Keywords: Acute survivorship; African-American; Breast cancer; Cultural competence; Health disparities.

Publication types

  • Review

MeSH terms

  • Adult
  • Aftercare / methods
  • Antineoplastic Agents / adverse effects
  • Black or African American / ethnology
  • Black or African American / psychology
  • Breast Neoplasms / ethnology
  • Breast Neoplasms / psychology*
  • Breast Neoplasms / therapy
  • Cancer Survivors / psychology*
  • Cognition Disorders / chemically induced
  • Communication
  • Diet
  • Exercise / physiology
  • Female
  • Fertility Preservation
  • Health Status Disparities
  • Heart Diseases / chemically induced
  • Humans
  • Mammaplasty / psychology
  • Middle Aged
  • Neoplasm Recurrence, Local
  • Peripheral Nervous System Diseases / chemically induced
  • Professional-Patient Relations
  • Quality of Life
  • Sexual Dysfunction, Physiological / etiology
  • Sexual Dysfunctions, Psychological / etiology
  • Surveys and Questionnaires

Substances

  • Antineoplastic Agents