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Eliminating Global Disparities in Breast Cancer Care through Clinical Research

From the Center for Clinical Cancer Genetics and Global Health, University of Chicago, Chicago, IL

Authors’ disclosures of potential conflicts of interest are found at the end of this article.

Address reprint requests to Corresponding and reprint author Olufunmilayo I Olopade, MBBS, FACP, Center for Clinical Cancer Genetics and Global Health, Department of Medicine, Section of Hematology/Oncology, University of Chicago, 5841 S. Maryland Ave, MC 2115, Chicago, IL 60637; e-mail: folopade{at}medicine.bsd.uchicago.edu

Overview: Breast cancer is the most prevalent cancer of women worldwide.^1,2 The World Health Organization (WHO) estimates there were 1.1 million new cases of breast cancer in 2004⁹ and 548,000 deaths from the disease in 2007.¹⁴ The majority of deaths occurred in low or middle-income countries.^1,3,5,14 Global breast cancer incidence and mortality have increased steadily,^1,3,10 with an estimated 0.5% annual rate of increase since 1990.¹ Disparities exist in breast cancer risk as a result of several factors, including ethnic differences in disease biology (evidenced by early onset, higher grade, and poor prognostic subtype breast cancers in black women¹³), regional differences in detection rates and disease reporting, and socio-economic status and access to healthcare determinants⁵. However, not all of the risk difference has been explained. Researchers in resource rich countries have been increasingly engaging in research and interventions aimed at understanding and eliminating these disparities in breast cancer burden. This write-up will attempt to briefly describe the epidemiologic, biologic, and management differences regarding breast cancer worldwide; discuss the role of factors such as inequitable resource allocation in sustaining the disparities; as well as briefly describe the collaborative activities of a North American research center striving to diminish the disparities in breast cancer care, by increasing the research capacity of West African centers to engage in significant and transformative research.