Black women have the highest death rate from breast cancer of all racial and ethnic groups, and are 40% more likely to die of the disease than are white women, according to a new report from the CDC.

Despite the decline in breast cancer death rates in the past 20 years, black women had higher death rates even though they had fewer new cases of breast cancer, noted the authors of  the November 2012 Vital Signs report. Compared with white women, black women have nine more deaths per 100 breast cancers diagnosed and higher numbers of advanced-stage disease (45% vs 35%).

According to the report, black and white women reported equal breast cancer screening in 2010: 74% of black women and 73% of white women aged 50 to 74 years said they had undergone mammography screening within the past 2 years. However, when abnormal mammogram results are noted, 20% of black women experience follow-up times of more than 60 days, compared with just 12% of white women. And although treatment should begin as soon as possible after cancer is found, only 69% of black women start treatment within 30 days, compared with 83% of white women.

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To improve this disparity, black women need more timely follow-up and improved treatment, contend the authors. Clinicians in particular are advised to be sure that women get recommended tests and treatments; to use electronic systems or other reminders to notify patients when they are due for a mammogram; and to continue to talk to women about their risk for breast cancer, explain test results, and refer patients to specialists as needed.