Breast cancer in African-American women. Review of the literature.

Decreased survival rates from breast cancer in the poor and in many African-American women are pressing public health problems. Health care providers are challenged to reduce breast cancer deaths in high-risk poor and African-American populations to achieve the National Cancer Institute's goal of reducing cancer deaths 50% by the year 2000. This article presents findings from a review of the literature concerning (a) the disproportionate distribution of cancer deaths in poor and African-American populations compared with non-poor white populations; (b) breast cancer detection initiatives and barriers to health services utilization; (c) primary prevention of breast cancer; and (d) broad strategies to empower poor and African-American women better to control their destiny through enhanced health practices and public policy initiatives.