Racial disparities in breast cancer mortality rates in many U.S. cities widened between 1990 and 2009, a study by the Sinai Urban Health Institute and Avon Foundation for Women finds.

The report, 2014 Racial Disparity in Breast Cancer Mortality Study (6 pages, PDF), analyzed breast cancer mortality rates in fifty metropolitan areas and found disparities between African-American and white women in thirty-nine cities during the 2005-09 period. In thirty-five of those cities, the gap had widened since 1990-94, the initial study period. The study also found that racial disparities in breast cancer mortality rates were greatest in Memphis, followed by Los Angeles, while the gap was smallest in New York City, followed by Baltimore.

The study, which was published in Cancer Epidemiology, also found that while breast cancer mortality rates for both white and African-American women fell between 1990 and 2009 in most metro areas, the rate declined twice as much for whites as for African Americans. Researchers attributed the finding to four key factors: differential access to screening, quality of the screening process, access to treatment, and quality of treatment.

"The geographical variation and growth in the black-white disparity over time shows that genetic factors comprise only a very small portion of the breast cancer mortality disparity," said Steve Whitman, the study's senior author and director of the Sinai Urban Health Institute. "Rather, we believe a more logical explanation for the disparity is that certain technological advances related to screening and treatment that became available in the 1990s — such as digital mammography, advances in surgery, and new drugs for treatment — have been less accessible to black women, who are disproportionately poor and un- or under-insured and less able to obtain access to these advances."

To access an interactive map of racial disparities in breast cancer mortality rates in each city, visit the Avon Foundation for Women Web site.