Racial and Socioeconomic Disparity in Breast Cancer Mortality: A Systematic Review and Meta-Analysis
Helena Fiats Ribeiro, Fernando Castilho Pelloso, Beatriz Sousa da Fonseca, Camila Wohlenberg Camparoto, Maria Dalva de Barros Carvalho, Vlaudimir Dias Marques, Mariá Românio Bitencourt, Kely Paviani Stevanato, Pedro Beraldo Borba, Deise Helena Pelloso Borghesan, Paulo Acácio Egger, Ana Carolina Jacinto Alarcão, Roberto Kenji Nakamura Cuman, Isabella Morais Tavares Huber, Márcia Edilaine Lopes Consolaro, Constanza Pujals, Carlos Laranjeira, Raíssa Bocchi Pedroso, Sandra Marisa Pelloso
Abstract
Background/Objectives: Breast cancer is one of the leading causes of female mortality worldwide, but significant racial and socioeconomic disparities persist in disease outcomes. This review aimed to analyze racial and socioeconomic inequalities in mortality and survival from breast cancer, identifying the impact of social risk factors on access to diagnosis and treatment. Methods: A systematic literature review and meta-analysis was performed following PRISMA guidelines. Eighteen studies published between 2014 and 2024 were included, with 11 contributing to the meta-analysis. Random-effect models were used to assess correlations between socioeconomic status, race, and clinical outcomes, including heterogeneity and publication bias analyses. Results: The strongest associations were observed between income, race, and breast cancer survival, with survival significantly worse among Black women and low-income populations (p < 0.001). Income also showed a strong positive correlation with clinical outcomes. In contrast, the overall effect on mortality was not statistically significant (p = 0.290), likely due to high heterogeneity across studies (I2 = 100%). These findings suggest that structural disparities in access to healthcare and early detection substantially affect survival rates. Conclusions: Racial and socioeconomic disparities in breast cancer outcomes remain critical public health challenges. Targeted policies to expand early diagnosis and ensure equitable access to effective treatment are essential to reduce these disparities and improve survival in underserved populations.