Comprehensive Screening Saves Lives for Older Women of Color

Women learn to be alert about breast cancer at a young age, for good reason. Only lung cancer is deadlier, and routine mammograms lower their risk of death. Yet most women who get breast cancer are older--half of all breast cancers are diagnosed at age 62 or later. Continued screenings for breast cancer and other conditions save lives, particularly for women of color.  

One in 5 Black women with breast cancer have aggressive cancers such as the “triple negative” type that isn’t identified in multiple biopsy tests. Without regular screenings, cancer may surface in Black women at more advanced stages. For these reasons, breast cancer in Black women is now the deadliest type of cancer.

Breast Cancer’s Unpredictable Spread

Once childbearing is in the past, often so are the pains or lumps that women experience before menopause. But cancer has a different biological clock, and no one can predict when cancer cells will begin to divide and grow. Breast cancer also attacks at different speeds, and it’s dangerous to assume that it will move slower in old age.

Of course, cancer is complicated. Family history plays a role in whether cancer will strike, but researchers say genes account for only a fraction of this racial disparity. Other elements might influence breast cancer too, from breastfeeding to health problems such as diabetes, heart disease and obesity. There are still unknowns about the biology of breast cancer, in part because minorities and older women are not well represented in clinical trials.

The American Cancer Society says the main cause of inequity is inadequate health insurance. Black women statistically have worse outcomes, but early diagnosis helps beat the odds. Affordability is a roadblock to detecting cancer early when treatment is easier and less costly. Black women are more often diagnosed at an advanced stage, do not get recommended care, or have delays in treatment.

All these factors lead doctors to recommend that women keep getting mammograms every year or two well after age 55. Even after 75, women need to have thoughtful discussions with their care team about whether limited mobility or other issues pose enough of a downside.

Add Screening to Annual Check-up Routine

Women deserve proper care at any age, including physical exams and proper follow-up. Annual wellness visits with a primary care doctor offer regular chances to get screened for cancers and other medical conditions:

• 1 in 5 cervical cancer diagnoses come after age 65. Doctors may recommend Pap or HBV tests if they have a weakened immune system, past abnormal Pap results or HIV. Pap smears after age 65 may make sense for women with a history of cervical lesions or cancer, whose mothers took a hormone called DES while pregnant, or who have a weakened immune system.
• Colorectal cancer screenings should continue regularly until age 75. Women with ulcerative colitis or a history of colon polyps may need tests more often.
• Blood pressure should be checked once a year. Black Americans have higher rates of hypertension. An immediate relative with high blood pressure is another reason to have frequent blood pressure tests.
• Diabetes blood tests every three years will check for healthy blood sugar levels. Weight, blood pressure or heart issues increase the risk of developing diabetes.
• Cholesterol should get checked every five years. People with diabetes, heart disease, kidney problems or weight issues need closer monitoring for artery-clogging fats in the bloodstream.
• Dental checkups once or twice a year will check your mouth for possibly cancerous conditions.
• Eye exams every year or two can look for glaucoma and other vision conditions.
• Difficulty hearing should be an alert to get a hearing test.

Even healthy women should have regular visits with a primary care doctor to get immunizations and other preventive care. Advice from a trusted medical adviser can help older women live longer, with less pain or other health issues.

Y0149_0006909_C