Ethnicity and Breast Cancer Stage in Ontario

In high-income countries, breast cancer mortality has been declining since the early 1990s because of a combination of breast cancer awareness, screening, and improvements in treatment1–3. In Canada, a country with universal access to health care and longstanding breast cancer awareness and advocacy programs, rates of participation in breast screening have plateaued and remain below the target of more than 70% for women 50–69 years of age4. Notwithstanding current debates about the value of organized screening mammography3,5,6, the effects of breast awareness programs and screening, whether by mammography or clinical breast examination, or both, remain unclear for populations in which cancer myths, stigma, and taboos are prevalent7. Since the early 2000s, significant efforts have been undertaken by public health units, principal cancer agencies, and researchers to identify populations who remain underserved, including those at risk of lesser access to or utilization of cancer services. Those priority populations include immigrants and ethnocultural minority communities8–13. Pilot programs have been implemented to improve breast cancer awareness and screening among immigrant and ethnocultural minority women in Ontario14–22, but it remains unclear whether such initiatives are making an impact; current trends would suggest otherwise4,12,15. Reports from the United Kingdom and North America suggest that women from minority groups ABSTRACT