I will comment from my experience as an advocate, activist for breast cancer, retired after 30 years from a cancer center, member of boards for Cancer for the underserved,diverse population.

It is all cultural ,an American black lady will not act the same as black lady from the Caribbean, Colombia,Brasil,Africa when it comes to their health, cultures,values,traditions are different.

While I was active in a cancer organization that targeted culture, I created a program of volunteers to teach in high school about cancer,symptoms, care,because the young could explain and teach parents.

We also sent volunteers to places where women meet to teach like churches.

We were very succesful.

We had a yearly Conference to address with role playing believes about health in different communities based on religion, ethnicity, culture.

We have community clinics, that diagnose for free, mobile mammography free, check local hospitals there are months for free breast exams,skin cancer and so on.

I collaborate with The Rose in Houston years back, a clinic example of dedication to the health of the underserved that are people with no insurance.

Once diagnosed one can qualify for Medicaid or Hospital Charity care.

One has to be responsible for one life, get second opinion, every hospital has social workers that work with patients that can have financial, insurance, work problems.

One reason why we get many coming to the USA to be treated because there are many options for who do not have medical insurance.

I believe is more a socio economic,cultural problem ,not a race problem.

I read this thread out of interest and probably shouldn't comment since I am not a racial minority, but here goes anyway...

I think you are both right, in that I think both poverty and culture are factors as to why someone might not see a doctor. I live in Toronto, which is a very multicultural community, with over 50% of our population being foreign born, and these issues regularly are front and center in the news. For example, because there is a distrust of the medical system within some cultural groups, right now there is a major effort underway within certain ethnic communities to ensure that people get the Covid vaccine when it is available to them (which for most people in Canada unfortunately won't be for quite a while yet). We have a large Muslim population, and the availability of female doctors (and better still, female Muslim doctors) is critical to ensuring that women within this community see a doctor when they need to. Just two examples.

The following webpage is specific to children, not women with breast cancer, but it highlights the role of culture in medical care:

How Culture Influences Health A guide for health professionals working with immigrant and refugee children and youth

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As for poverty, obviously that is a huge issue when it comes to health care, although probably less so in Canada than in the U.S., because we have universal healthcare. Still, we face issues with having two few doctors located in poor urban areas (and more generally, within rural communities throughout the country), which means that if there is no doctor available to see, it doesn't really matter that it costs nothing to see a doctor. Someone who is struggling with 2 or 3 jobs and can't afford to take time off might visit a doctor who is conveniently located, but they aren't going to go to the trouble of searching for a doctor outside of their neighbourhood, or take the time and incur the expense to get to that doctor.

To the original post, I don't know whether in Canada we have the same issues with racial disparities in breast cancer stage at time of diagnosis, but I do know that overall we do have similar issues in terms of differences in medical care and outcomes for racial minorities. So while insurance is one factor that drives these differences in the U.S., there is obviously more to it, since we don't have the same insurance issues in Canada but we have the same problem.