Cancer and the Black Community

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2012 National Black Members' Conference
21 September 2011

Conference is concerned by research that has shown greater numbers of women of African, African-Caribbean and Pakistani origin are likely to be diagnosed with breast cancer that has spread than white women. A breast cancer incidence and survival study found that 17% of Pakistani women, 15% of African women, 11% of African Caribbean women and 10% of Chinese women were diagnosed with breast cancer that had spread compared with 7% of white women. The study concluded that the major difference was that the rate of early detection among white women was very high.

Research has also indicated that there are key differences across ethnic groups in the UK in breast cancer awareness, disease development and treatment success rate. Cancer Research UK is working with the NHS and the department of Health on the National Awareness and Early Diagnosis Initiative and they have advised that early diagnosis can make a real difference to the success of cancer treatment.

This message is even more vital for Black African and African Caribbean women, as recent research also suggests that they might develop breast cancer significantly earlier than white contemporaries. Results of a study by Cancer Research UK found that Black African and African-Caribbean women were diagnosed with breast cancer at an average age of 46 while white patients were diagnosed at an average age of 67. The tumours in younger patients were more likely to be aggressive and less likely to respond to newer types of targeted breast cancer treatment. While the screening age is being lowered, it is still not low enough to respond to the urgent needs of Black women.

It is not just Black women who are at risk from breast cancer. Men with breast cancer show the same racial disparities in survival as do women with the disease, according to a population-based study. Black men with breast cancer were three times more likely to die from the disease than white men. Additionally, Black men in England are three times more likely to develop prostrate cancer; they are also more likely to develop it five years earlier than white men. There are other disproportionate cancer risks confronting Black people. South Asian and Chinese people face a higher-than-average risk of mouth cancer

Conference is concerned that many Black people in the UK have a low awareness of the signs and symptoms of cancer. Figures have shown that at least 46% of Black people were unsure of what the signs or symptoms were or how to reduce the cancer risk. This was despite the fact that 61% of the people surveyed had had a family member with cancer. Conference is also concerned that people with darker skin colouring are at greater risk of dying from skin cancer than white people due to late detection, despite a lower incidence of skin cancer among people of Asian, African and other Black backgrounds. Because of a false perception that Black people do not get skin cancer, it is often diagnosed later, causing a higher risk of death.

Conference also notes that a new study has found that members of the South Asian community are 15 per cent less likely to attend breast cancer screening and only half as likely to accept an invitation to be screened for bowel cancer as other groups.

Conference notes that there is a lack of understanding of the needs of Black people who are undergoing cancer treatment. In particular their access to culturally appropriate wigs and prostheses is limited. For instance, a study found that Black cancer patients are being told that the NHS is unable to provide wigs especially for Black people, who are at their most vulnerable when their hair starts falling out from cancer treatment. The study also found that there are limited selections of coloured/tinted prostheses available for Black people and that the ones available do not appear real and are more expensive than white prostheses. The study revealed that coloured/tinted prostheses can take up to 12 weeks to be delivered compared to white prostheses which are always in stock. Data from an English patients survey found that Black people reported substantially more negative experience and are not satisfied with NHS primary care services.

Conference notes with concern that a post code lottery confronts women accessing prosthetic services. Where a patient lives will determine how much funding is available. Even where doctors make recommendations for silicone prosthetics which are much more suitable for black people, denial of funding from the local Primary Care Trusts or Strategic Health Authorities may prevent the patient from accessing that prosthetic. Instead a cheaper unsuitable version will replace it.

Given these research findings, it is apparent that raising awareness about cancer risks, signs and symptoms and the importance of early detection and treatment is vital, life saving work. It is also clear that Black cancer patients are not getting the same care as their white counterparts.

Conference welcomes initiatives such as the mobile breast cancer screening units which have been used to improve uptake of screenings, particularly within Black communities.

Conference is alarmed that the Government’s reforms will erode the NHS’ commitment to equality, both to its employees and the communities it serves. Privatisation will weaken UNISON’s ability to organise and fight for equality within the health service and increase existing inequalities in access to services.

Conference calls on the NBMC to:

1.Raise awareness of the signs and symptoms of cancer amongst all sections of the Black community including working with relevant community and voluntary organisations and encourage Black women to undertake screenings when they are sent appointments.

2.Raise awareness of the difficulty that Black people encounter in getting culturally appropriate wigs and prostheses.

3.Work with Labour Link and the NEC to campaign to save our NHS and to ensure it remains a public service that serves all communities with no inequality of access.