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Guidelines & Advice
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Race, Ethnicity and Indigeneity in Breast Cancer

 

What’s on this page

How Race, Ethnicity or Indigeneity Affect Breast Cancer

Someone’s race, ethnicity or Indigeneity can affect their chance of getting breast cancer and how the disease may affect them. For example, Ashkenazi Jewish people are more likely to have a genetic change that increases their chance of getting breast cancer.

Race, ethnicity or Indigeneity can also affect the age when someone might get breast cancer and the type of breast cancer they might get. Both of these things can affect treatment options and how well they work. The reasons for these differences are not fully understood. But we do know that biology is not the only explanation. People from certain racial, ethnic or Indigenous groups can also be treated differently in society.

In general, people who are racialized or Indigenous are more likely to experience:

  • Unequal or inadequate access to health care. This can cause a delay in diagnosing breast cancer until it is more advanced, making it more difficult to treat.
  • A lack of cultural safety or mistrust in the health care system. This can mean people are less likely to talk with health care providers or ask them for advice or help.
  • Racism in health care and society. This can make it more likely they are exposed to risk factors that increase the chance of getting breast cancer or of dying from breast cancer.

Make an Informed Decision About Getting Checked for Breast Cancer

Understanding how your background might affect your breast cancer risk can help you make an informed decision about getting checked, or screened, for breast cancer.

For example, someone from a population that tends to get breast cancer at a younger age might consider starting to get checked sooner. Or someone from a population that tends to get a fast-growing type of breast cancer may want to get screened regularly to catch any signs of cancer as early as possible.

Along with your racial, ethnic or Indigenous background, there are other things that can also affect your chances of getting breast cancer, including:

  • family history of breast or ovarian cancer
  • medical history
  • lifestyle

It is important to think about all these things so that you can make an informed decision about whether to get checked for breast cancer. Talking about it with your family doctor or nurse practitioner and learning more about your chance of getting breast cancer can help you make the best decision for your health.

Research to Help You Decide

Overall, there is not enough research to support specific recommendations about breast cancer screening for people based on race, ethnicity or Indigeneity.

Some research does exist, and we have summarized it here. We have also included links to the research in case you want to review it yourself to learn more.

Where the research is from

Where possible, we’ve shown research from Ontario. We also have included some research from the rest of Canada, the United States and the United Kingdom to help fill in gaps where there is no research from Ontario.

Some research may not apply to you

Be careful about assuming research results from outside of Ontario apply to you or others living in the province. Differences in our health care systems, social influences and environment mean that results from other provinces or countries may not apply here.

How the research describes gender

The use of the word “female” when describing the research reflects how the data were collected. We acknowledge that it does not include all gender identities . As a result, some people included in the research may be misgendered if their gender is different from their sex assigned at birth.

Research on Black Populations

  • Research from Canada, the United States and the United Kingdom shows that Black females have a lower chance of getting breast cancer than white females ages 40 to 79.
  • Research from the United Kingdom shows that:
    • Black females of African and Caribbean descent are diagnosed with breast cancer at a younger age than white females.
    • Black females of African descent are often diagnosed with breast cancer at much later stages of the disease.
  • Research from Canada and the United Kingdom shows that Black females are more likely to be diagnosed with more aggressive (faster growing) subtypes of breast cancer that can be harder to treat.
  • Research from Canada and the United States shows that Black females are more likely to die from breast cancer than white females.

Read the research

Research on Asian Populations

  • Canadian research shows that:
    • Filipina females ages 40 to 59 get breast cancer at a higher rate than white females.
    • Arab females ages 50 to 59 get breast cancer at a higher rate than white females.
    • Filipina females ages 40 to 59 are less likely to die from breast cancer than white females.
    • dArab females ages 50 to 59 are less likely to die from breast cancer than white females.
  • United Kingdom research shows that:
    • Asian females get breast cancer at a lower rate than white females.
    • Indian and Pakistani females are diagnosed with breast cancer 3 to 6 years earlier on average than white females.
    • Females with Indian, Bangladeshi and Pakistani backgrounds are more likely to be diagnosed with breast cancer at a later stage than white females.
  • United States research shows that Asian females are less likely to die from breast cancer than white females and all females in the United States.

Read the research

Research on Ashkenazi Jewish Populations

United States research shows that people of Ashkenazi Jewish descent may be at higher risk of developing breast cancer because changes in the BRCA1 and BRCA2 genes are more common in this population.

Does this research apply to you?

If you are of Ashkenazi Jewish descent, age 30 to 69 and have a personal or family history of breast or ovarian cancer, you may qualify to screen through the High Risk Ontario Breast Screening Program (OBSP).

To find out more about the High Risk OBSP, visit Screening for Breast Cancer and click on “When to Get Screened”.

Read the research

Breast Cancer Screening for Women at Higher-Than-Average Risk: Updated Recommendations From the ACR (Journal of the American College of Radiology)

Research on First Nations, Inuit and Métis Populations

“Other females in Ontario*” (followed by a * symbol) means females living in Ontario, except for First Nations people in the Indian Register and Métis people in the Citizenship Registry.

  • Ontario research shows that:
    • First Nations females get breast cancer at a lower rate and are less likely to die from breast cancer than other females in Ontario. But First Nations females in Ontario who do get breast cancer are less likely to survive than other females with breast cancer in Ontario*.
    • First Nations females are diagnosed with breast cancer at a similar age and stage as other females in Ontario*.
  • Canadian research shows that:
    • Métis women get breast cancer at a significantly higher rate than non-Indigenous women in Canada.
    • Female residents of Inuit Nunangat develop breast cancer at a lower rate than female residents in the rest of Canada.
    • First Nations and Métis females ages 60 to 69 are more likely to die from breast cancer than white females.

Read the research

Research on Pacific Islander Populations

Pacific Islander females in the United States are less likely to die from breast cancer than white females and all females in the United States.

Read the research

Race and Ethnicity-Adjusted Age Recommendation for Initiating Breast Cancer Screening (JAMA Network Open)

Research on Hispanic Populations

Hispanic females in the United States are less likely to die from breast cancer than white females and all females in the United States.

Read the research

Race and Ethnicity-Adjusted Age Recommendation for Initiating Breast Cancer Screening (JAMA Network Open)

Research on Caribbean Populations

United Kingdom research shows that females with Caribbean backgrounds are more likely to be diagnosed with breast cancer at a later stage than white females.

Read the research

Black women in England are at greater risk of late cancer diagnosis than white women (British Medical Journal)

Learn More About Breast Cancer Screening and Prevention

My CancerIQ

Complete the My CancerIQ breast cancer risk questionnaire to better understand your chances of getting breast cancer. While MyCancerIQ does not ask about Indigenous ancestry, race or ethnicity, it does ask about your personal health, family history and lifestyle, which also affects your breast cancer risk.

Screening for Breast Cancer

Learn how breast cancer screening works in Ontario, how to access screening services and find links to more resources.

Cancer prevention and screening in Indigenous and racialized populations