Socioeconomic status and breast cancer disparities

While the full effects of SES or deprivation as an extrinsic influence on breast carcinogenesis have yet to be explored, socioeconomic factors in all probability contribute to a great deal of breast cancer disparities and affect breast cancer 6 Socioeconomic Status and Breast Cancer Disparities 153 outcomes across the entire cancer continuum. These factors include many considerations beyond race and ethnicity. Although there are several racial and ethnic differences in incidence, mortality, survival, and treatment protocols, these differences do not explain fully why some groups suffer disproportionately more from breast cancer disparities than others. Regardless of race, poor persons are more likely to have more undesirable breast cancer outcomes, thus again shining the light on poverty, as well as on the devastating toll of a variety of often interrelated factors, including barriers to health care, lack of health insurance, and poor patient-physician communication. At the same time, racial and ethnic disparities, primarily between blacks and whites, have received significant attention and are better documented than many other disparities, although there are still some gaps about their extent across the cancer continuum.As we go forward, more attention should focus on the interplay of other socioeconomic factors, in addition to race and ethnicity, which would then rightfully give attention to bring other socioeconomically deprived groups into the discussion as well. Finally, a great deal of the research thus far has focused on screening, treatment, and survival. Much of this research is descriptive and has done very little to offer solutions for eliminating disparities. From this perspective, it is important to remember that SES is also confounded by other factors such as lifestyle, dietary, and cultural factors. To be sure, genetics will complicate the picture further. Considerable attention should be given to genetic ancestry and study designs that better measure SES in investigating breast cancer disparities. Moreover, as we are now in an era of personalized medicine and emerging technologies, understanding better the influence of SES on these new advancements and their relationship to breast cancer disparities will be critical. Finally, and most importantly, the beginning and end goal in reducing and eliminating breast cancer disparities is not to prove the influence of one particular type of factor but rather to achieve equal treatment and, ultimately, equal outcomes for all.