Chicago works to close the breast cancer race gap

By Courtney Dillard

Attendees listen to the findings of the study at last week's Beyond October event at the Chicago Urban League.
Attendees listen to the findings of the study at last week’s Beyond October event at the Chicago Urban League.

The mortality gap in breast cancer between black women and white women in Chicago has decreased for the first time in 20 years. Up until 2007 it increased every year.

Now, a new study shows the gap has narrowed significantly. In 2007 black women in Chicago were dying of breast cancer at a rate 62 percent greater than white women. That disparity dropped suddenly to 40 percent between 2008 and 2010, which translates to 25 black women’s lives saved.

“We’ve saved 25 women, 25 mothers and 25 friends,” said Teena Francois-Blue, associate director of community initiative for the Metropolitan Chicago Breast Cancer Task Force.

A study released last week at the Chicago Urban League outlined the inconsistency of treatment across the state of Illinois, as well as plans for the future.

The study, conducted by the task force, found that the quality of mammograms and treatment had a more prominent effect on the racial disparity than genetics. Similar metropolitan cities, like New York and Baltimore, have a lower mortality disparity rate. San Francisco has no disparity, the study said. “There are two issues here. There’s access and there’s quality. They go hand in hand,” said Dr. Anne Marie Murphy, director of the task force. “There’s no point in accessing poor quality, and there’s no point in having high quality that’s not actually available.”

The neighborhoods affected most by the disparity are on the South and West sides of the city. Seventeen of those 20 neighborhoods are predominantly African-American. Only one Breast Imaging Center of Excellence, Advocate Trinity Hospital, is in a high breast cancer mortality community.

“Most women assume that they are getting a high quality mammogram no matter where they go,” said Murphy. “But the reality is that not all mammograms are created equal.”

The Task Force partnered with the Illinois Department of Public Health to collect data about treatment quality from mammography centers in the Chicago area. Of the 160 mammography centers that submitted data, only two met all 11 quality benchmarks. Facilities that are public providers were less likely to meet the benchmarks. Though the findings for all the centers are available collectively, specific data sets are confidential.

“These studies give us concrete data so we can see exactly where we need to focus our efforts, and as a result, we’re going to have a whole bunch of providers improving quality,” said Julie Hamos, director of the Illinois Department of Healthcare and Family Services.

The Task Force plans to offer free expert training to mammography technologists funded by a grant from the Coleman Foundation. They are also working on a third- party evaluation of three pilot hospitals in collaboration with Northwestern’s Robert H. Lurie Comprehensive Cancer Center to be completed next spring.

Dr. Bechara Choucair, commissioner of the Chicago Department of Public Health, announced the state’s commitment to using big data to target women who are at high risk for breast cancer. Earlier this year the state used microtargeting to send postcards urging 5,000 women at high risk for breast cancer to get mammograms at Mercy Hospital, a designated Center of Excellence.

“We can’t roll a hospital into a neighborhood, but we can navigate women to quality care,” said Dr. David Ansell., president of the task force.

Though the mortality gap has decreased, the question of high quality, accessible breast cancer treatment still has not been answered.

“I have seen over the years that our health care system is not an equitable system. Not everybody accesses the best care,” said Murphy. “We’ve really been interested in spending our time making the system a little bit fairer.”