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Breast Health and Cancer Awareness: Addressing Breast Cancer Disparities from Etiology to Survivorship

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Global Health".

Deadline for manuscript submissions: 30 September 2025 | Viewed by 2515

Special Issue Editor

Dr. Tisha Felder

E-Mail Website
Guest Editor
College of Nursing, University of South Carolina, Columbia, SC 29208-4001, USA
Interests: breast cancer prevention; breast cancer survivorship; breastfeeding; Black/African American health; racial health disparities; health equity

Special Issue Information

Dear Colleagues,

The surge in global breast cancer incidence and mortality underscores the urgency for enhanced awareness, prevention, and treatment. Despite advancements in breast cancer research, the complex interplay of genetic predispositions, environmental factors, and socioeconomic and racial disparities further exacerbates the challenge. Understanding breast health demands not only examining risk factors and health behaviors but also social determinants and social drivers of health that contribute to breast cancer outcomes among diverse populations. The use of various research designs and methods across the breast cancer control continuum is critical for confronting breast cancer disparities and achieving optimal breast health and equitable care.

Dr. Tisha Felder
Guest Editor

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Keywords

  • breast health
  • breast cancer
  • prevention
  • risk factors
  • diagnosis and treatment
  • survivorship
  • screening tests
  • genetic testing
  • health disparities
  • social drivers of health
  • life course

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Published Papers (3 papers)

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Research

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11 pages, 274 KiB  
Article
Multilevel Factors Influencing Perceived Barriers to Adjuvant Endocrine Therapy Among Breast Cancer Patients at Medication Onset
by Timothy Cocozza, Rita Smith, Ana Maria Lopez, Shari Rudoler, Rachel Slamon, Tingting Zhan, Jazmarie L. Vega, Minal Dhamankar, Aruna Padmanabhan, Suzanne M. Miller and Kuang-Yi Wen
Int. J. Environ. Res. Public Health 2025, 22(5), 734; https://doi.org/10.3390/ijerph22050734 - 6 May 2025
Viewed by 422
Abstract
Purpose: Adjuvant endocrine therapy (AET) significantly diminishes recurrence and mortality risks in hormone receptor-positive breast cancer (BCa) patients. Nonetheless, suboptimal adherence and premature discontinuation during the initial year of treatment undermine these positive outcomes. This study aims to understand the potential diverse factors [...] Read more.
Purpose: Adjuvant endocrine therapy (AET) significantly diminishes recurrence and mortality risks in hormone receptor-positive breast cancer (BCa) patients. Nonetheless, suboptimal adherence and premature discontinuation during the initial year of treatment undermine these positive outcomes. This study aims to understand the potential diverse factors associated with perceived barriers to AET compliance at the onset of medication. Methods: We assessed perceived barriers to AET using the ASK-20 instrument for BCa patients initiating AET within 3 months. Our survey also included demographic variables (e.g., musculoskeletal symptoms) and clinical traits (e.g., medication type). Stepwise regression analyses were employed to elucidate the links between multilevel factors and perceived barriers to AET adherence. Results: In our cohort of 272 women, the mean ASK-12 score was 38.2 +/− 9.2 (range 20–100). In the multivariable regression model, greater perceived barriers to adhering to AET were found to be associated with African American ethnicity (Β  =  2.47; 0.53–4.21; p  <  0.05), lower self-efficacy in medication management (Β  =  −0.80; −1.03–−0.58; p  <  0.001), higher psychological distress (Β  =  2.79; 0.61–4.97; p  <  0.05), increased reported distress related to musculoskeletal side effects (Β  =  0.64; 0.31–0.97; p  <  0.001), weight gain symptoms (Β  =  0.61; 0.18–1.03; p  <  0.05), less family support (Β  =  −0.38; −0.53–−0.13; p  <  0.05), and higher levels of concern pertaining to AET (Β  =  0.64; 0.41–0.87; p  <  0.001). Conclusions: Modifiable factors are associated with women’s perceived barriers to AET at the onset of treatment. Proactively addressing patient concerns about AET, improving self-regulatory skills for medication management and family support, and enhancing symptom management strategies, along with addressing distress at the onset of treatment, hold promise for mitigating barriers to AET. Furthermore, recognizing the distinctive challenges faced by African American subgroups is crucial, necessitating culturally tailored interventions to reduce potential disparities and ensure equitable access and adherence to AET. Continued research and tailored interventions are important for optimizing outcomes and reducing the impact of modifiable barriers on AET adherence. Full article
(This article belongs to the Special Issue Breast Health and Cancer Awareness: Addressing Breast Cancer Disparities from Etiology to Survivorship)
13 pages, 657 KiB  
Article
An Investigation of Travel Distance and Timeliness of Breast Cancer Treatment Among a Diverse Cohort in the United States
by Swann Arp Adams, Oluwole Adeyemi Babatunde, Whitney E. Zahnd, Peiyin Hung, Karen E. Wickersham, Nathaniel Bell and Jan M. Eberth
Int. J. Environ. Res. Public Health 2025, 22(2), 176; https://doi.org/10.3390/ijerph22020176 - 27 Jan 2025
Cited by 1 | Viewed by 1033
Abstract
Travel to and from distant cancer treatment facilities can place a significant burden on cancer patients, particularly rural and minority survivors. Thus, the purpose of our investigation was to examine the association between patient travel distance and delays in types of treatment for [...] Read more.
Travel to and from distant cancer treatment facilities can place a significant burden on cancer patients, particularly rural and minority survivors. Thus, the purpose of our investigation was to examine the association between patient travel distance and delays in types of treatment for breast cancer (surgery, radiation, chemotherapy, and hormonal therapy) and treatment delays. Using a novel linkage between the state cancer registry and administrative data from Medicaid and a private insurance plan, 2155 BC patients were successfully linked to create the cohort. ArcGIS was used to geocode all case residences and treatment facility addresses and calculate network distance between the residence and each facility. Logistic regression models were used to calculate the adjusted odds of being delayed versus timely by street distance. Odds of late surgery were increased by 1% (95% CI: 1.00, 1.01) for each one-mile increase from the patient’s residence to the treatment facility. In race-stratified models, the odds of late treatment for Black patients increased by 3% per mile (95% CI 1.01, 1.06) for radiation. Increased travel distance appears to significantly increase treatment delays for surgical, radiation, and chemotherapeutic treatments for women with BC, especially among Black women. Full article
(This article belongs to the Special Issue Breast Health and Cancer Awareness: Addressing Breast Cancer Disparities from Etiology to Survivorship)
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Other

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18 pages, 564 KiB  
Systematic Review
A Systematic Review of Cardiovascular Health Among Cancer Survivors
by Miriam A. Miles, Oluseun Akinyele, Abigail A. Ninson, Nicole Caviness-Ashe, Cha’Breia Means, Le’Andrea Anderson-Tolbert, Tuchondriana Smith, Reagan Coleman, Laura Q. Rogers, Joshua J. Joseph, Laura C. Pinheiro and Timiya S. Nolan
Int. J. Environ. Res. Public Health 2025, 22(6), 920; https://doi.org/10.3390/ijerph22060920 - 10 Jun 2025
Viewed by 276
Abstract
Cardiovascular disease (CVD) is the most common non-cancer cause of death among cancer survivors. Lifestyle and clinical factors associated with cancer mortality are also associated with cardiovascular mortality. The American Heart Association (AHA) has termed these factors “cardiovascular health” (CVH), using Life’s Simple [...] Read more.
Cardiovascular disease (CVD) is the most common non-cancer cause of death among cancer survivors. Lifestyle and clinical factors associated with cancer mortality are also associated with cardiovascular mortality. The American Heart Association (AHA) has termed these factors “cardiovascular health” (CVH), using Life’s Simple 7 (LS7) or “Life’s Essential 8 (LE8)” to determine poor, intermediate, and high (ideal) CVH. Further, less than ideal CVH is associated with higher cancer mortality. Yet, CVH among cancer survivors remains understudied. This systematic review examined the extant literature, providing a comprehensive report of the findings addressing CVH among cancer survivors. Methods: Using PRISMA guidelines, we systematically examined CVH among cancer survivors (including patients) within PubMed, Scopus, CINAHL, and Embase databases without date limitations from June 2024 to December 2024 using the following keywords: “cancer survivors”, “cancer patient”, “cardiovascular health”, and “cardiovascular risk factors”. Two reviewers independently accessed articles in concordance with LS7 and LE8 metrics. The included studies were examined and assessed for risk of bias and synthesized to elucidate themes of CVH among cancer survivors. Results: We retrieved 2935 studies examining breast, gynecological, endometrial, prostate, colon, lung, lymphoma, and skin cancer survivors published from 2002–2024. Overall, 10 studies met criteria utilizing LS7 or LE8 CVH health outcomes (4 LS7, 5 LE8, and 1 LS7/LE8), ages 40–70 years, with a population (n = 35,980) consisting of mostly female, non-Black individuals; mean survivorship was 7.2 years. Four themes emerged: CVH outcomes among cancer survivors, social factors impacting CVH outcomes, associations of CVH, and other health outcomes opportunities for CVH awareness. Conclusions: We found that cancer survivors frequently report less than ideal CVH outcomes and would benefit from education/empowerment to support lifestyle changes that improve CVH. Full article
(This article belongs to the Special Issue Breast Health and Cancer Awareness: Addressing Breast Cancer Disparities from Etiology to Survivorship)
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