UCalgary Research Reveals Breast Cancer Care Disparities for Black Women in Canada

Groundbreaking UCalgary Focus Groups Uncover Hidden Barriers

Researchers at the University of Calgary, led by Bukola Salami, the Canada Research Chair in Black and Racialized Peoples' Health, have conducted an in-depth investigation into breast cancer care disparities for Black women in Canada. Through focus groups involving over 100 Black women and community stakeholders across Alberta, funded by the Canadian Cancer Society in partnership with the African Cancer Support Group, the study reveals profound systemic issues hindering early detection and effective treatment. 61 59 This community-led approach emphasizes listening directly to those affected, highlighting unconscious biases, cultural stigmas, and access gaps that contribute to poorer outcomes.

The qualitative research underscores how breast cancer screening programs, while effective for many, often fail Black women due to a lack of tailored outreach and trust-building measures. Participants shared experiences of dismissed concerns and inadequate information, pointing to the need for health systems to adapt beyond standard protocols.

Alarming Statistics Paint a Stark Picture of Disparities

Breast cancer remains the most commonly diagnosed cancer among Canadian women, with an estimated 31,900 new cases in 2025 alone, affecting about 1 in 8 women over their lifetime. 50 However, Black women face disproportionate burdens: they are 45% more likely to be diagnosed before age 50, outside routine screening windows of 45-74 years recommended by Alberta Health Services. Moreover, up to 70% higher mortality rates plague this group compared to White women, with 26% diagnosed at advanced stages 3 or 4 versus 17% for White women. 61

National data from linked census and cancer registry studies confirm these trends. Black women exhibit a lower overall age-standardized incidence but elevated rates in younger age groups, particularly Caribbean-origin women aged 30-39 (58.7 vs. 43.1 cases per 100,000 person-years). 60 Triple-negative breast cancer (TNBC), an aggressive subtype lacking targeted therapies and associated with poorer survival (47% five-year for stage III, 7% for stage IV), occurs in 17.1% of Black cases versus 9.9% in White women, rising to 21.8% among Central/West African ancestry. 60

Unconscious Bias and Mistrust: Core Barriers Identified

The UCalgary study pinpoints unconscious bias as a primary obstacle, where providers make assumptions about Black women's pain tolerance, health literacy, age, or knowledge levels, often dismissing symptoms. Historical mistrust, rooted in events like the Tuskegee syphilis study, compounds this, leading to delayed screenings. Cultural stigmas around discussing breast health further deter participation. 61

• Unconscious assumptions by providers about patient knowledge and pain thresholds.
• Historical medical mistrust influencing care-seeking behaviors.
• Cultural taboos and lack of family discussions on breast health.
• Inadequate culturally relevant educational materials.

Additionally, side effects like hair loss, hyperpigmentation, and scarring on darker skin tones are poorly addressed, affecting decisions on chemotherapy or reconstruction.

The Aggressiveness of Breast Cancer in Black Women Explained

Triple-negative breast cancer (TNBC), defined as lacking estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER2) expression, responds less to hormone therapies and requires chemotherapy, which carries higher toxicity risks. Black women's higher TNBC prevalence (up to double in some studies) stems from genetic, environmental, and socioeconomic factors, with earlier onset peaking at ages 42-60 versus 65 for White women. 58 This demands tailored screening starting younger, yet current guidelines overlook these risks.

Underrepresentation in clinical trials (less than 5% Black participants typically) perpetuates gaps in race-specific data, limiting precise risk models and protocols.

Community Voices: Real Stories from Black Survivors

Focus group participants like Adeola Adesemowo shared transformative experiences: "I found a community where I could share my story without shame. Do not be afraid. Go for your checks." Yinka Oladele of the African Cancer Support Group stresses, "The research in the Black community is very low. We are just bringing it out there because it can only be done by us, for us." 61

These narratives reveal emotional isolation, with survivors craving peer support to navigate appointments, interpret results, and combat stigma. Grassroots groups fill voids left by mainstream services, fostering networks that boost screening willingness from as low as 15% in some reports.

Broadening the Lens: Complementary Canadian Research

Beyond UCalgary, a 2025 study by Anna N. Wilkinson analyzed census-linked data, confirming Black women's mean diagnosis age of 43 versus 50.5 for White women, with over 50% of Black cases under 50 in certain ancestries. 60 University of Ottawa research echoes earlier peaks for non-White groups and doubled TNBC in Black women. 58

Screening disparities persist: ethnic groups from West Asia, South Asia show lower mammography uptake, per Salami's prior publications. 81 These university-led efforts underscore higher education's role in health equity.

Opportunities abound for researchers; explore research jobs or clinical research positions in Canada at AcademicJobs.ca.

Pathways to Equity: Recommendations from the Frontlines

The study proposes actionable solutions:

• Culturally tailored outreach using peer navigators embedded in communities.
• Mandatory unconscious bias training for providers.
• Policy shifts for earlier screening and inclusive trials.
• Conversation circles grounded in African traditional knowledge.
• Increased Black representation in cancer registries and research.

Bukola Salami envisions rolling out interventions to enhance awareness and follow-up, potentially slashing late-stage diagnoses. 61 Organizations like Black Health Alliance advocate similar systemic changes.

UCalgary's Leadership in Racialized Health Research

Salami's work builds on her portfolio, including screening disparity analyses, positioning UCalgary as a hub for migrant and Black health studies. Faculty like her drive policy impact, training future leaders via programs linking research to practice. Aspiring academics can find faculty positions or postdoc opportunities in health sciences.

This research exemplifies how Canadian universities foster inclusive science, addressing social determinants step-by-step: from data collection to intervention design.

Future Outlook: Bridging Gaps Through Collaboration

With Canada's Black population growing (over 1.5 million), ignoring disparities risks widening inequities. Promising trends include community partnerships and precision approaches, like ancestry-specific risk models. Yet, sustained funding and diverse trials are crucial. By 2030, targeted strategies could align outcomes across groups if implemented province-wide.

Photo by Chris TDL on Unsplash

Empowering Change: Next Steps for Stakeholders

Health authorities must prioritize equity audits, while Black communities expand navigator programs. Researchers, consider contributing via research assistant roles. For career growth in this field, check how to write a winning academic CV.

In conclusion, UCalgary's revelations demand urgent action. Rate professors advancing such work at Rate My Professor, search higher ed jobs, and explore university jobs or higher ed career advice to join the fight.