SYSTEMATIC REVIEW article
Front. Oncol.
Sec. Breast Cancer
Volume 15 - 2025 | doi: 10.3389/fonc.2025.1562672
Structural racism as a Leading Cause for Racial Disparities in Breast Cancer Quality of Care Outcomes: A Systematic Review
Provisionally accepted
- Stanford Healthcare, Stanford, United States
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Background: Non-Hispanic Black women have a disproportionately higher breast cancer mortality rate compared to non-Hispanic white women. Structural racism embedded within societal systems plays a fundamental role in perpetuating these persistent disparities. This systematic review aims to examine the relationship between structural racism and breast cancer quality of care outcomes across various racial and ethnic groups.Methods: Following the PRISMA guidelines, we conducted a systematic review of PubMed, Embase, and CINAHL for studies published until October 30, 2024, that examined the relationship between structural racism and breast cancer quality of care outcomes. We employed the Healthy People's Social Determinants of Health (SDOH)framework to identify structural racism measures within these five themes: economic stability, education access, healthcare access, neighborhood and built environment, and social and community welfare. Breast cancer quality of care outcomes were assessed using the Donabedian quality of care model which encompasses three components of quality: process measures, structural measures, and outcome measures.We conducted a systematic review of 262 studies that included at least one measure of structural racism linked to a breast cancer quality of care outcome. Of these, 29 studies met the eligibility criteria for inclusion. The most frequently examined measures of structural racism were those related to residential segregation and redlining, which pertain to neighborhood and built environment SDOH domains. The predominant finding across the studies was that both residential segregation and redlining were significantly associated with adverse breast cancer outcomes. Theses outcomes included higher mortality rates, laterstage diagnoses, and suboptimal treatment. These effects exhibited variability based on race, comorbidity, and neighborhood characteristics, highlighting the complex role of structural racism in perpetuating disparities in breast cancer outcomes.The complex relationship between measures of structural racism and breast cancer quality of care outcomes underscores the necessity for ongoing research to understand the pathways through which structural racism impacts health outcomes. Understanding these pathways is essential for developing targeted interventions and promoting health equity in breast cancer care.
Keywords: breast cancer, Structural Racism, SDOH, quality of care, cancer care
Received: 17 Jan 2025; Accepted: 19 Jun 2025.
Copyright: © 2025 Abdelhadi, Williams and Yan. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Ola Abdelhadi, Stanford Healthcare, Stanford, United States
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.