It has been 50 years since President Richard Nixon declared “war on cancer” with the signing of the National Cancer Act. While treatments have improved and mortality rates have gone down, minorities are not seeing those benefits at the same rates as White patients.

Tracy Tomer had her first mammogram at age 53, after feeling a lump in her breast. She was diagnosed with breast cancer, but there were delays before the treatment began.

“In this area that I live in, there’s no mammogram service over here, there’s no chemo service over here, there’s no radiation,” Tomer said. 

Black Women are more likely than White women to have tumors missed during screening and to have delays in diagnosis and treatment. One reason is access to care.

“All the appointments were so far away from one another,” Tomer said. “It’s really a bad situation for women of color in this neighborhood.”

When it comes to breast and other cancers, the hard truth is there is a racial divide. While Black and White women have the same chance of getting breast cancer, Black women are more likely to be diagnosed with advanced cancer and are 40% more likely to die from it.

Tomer’s surgeon, Dr. Vivian Bea, chief of breast surgical oncology at New York-Presbyterian Brooklyn Methodist Hospital, is trying to change that equation.

“There are biases, there are implicit and explicit biases that exist in the health care system,” she said. “We have to look at the finances, the transportation. And then, you can have a cancer treatment center, but if it’s not accessible, patients cannot get to those areas.”

There are also racial differences in the biology of tumors and the types of breast cancer.

“Black women are more likely to be diagnosed with triple negative breast cancer, which is more difficult to treat,” Bea said.

In the 1990s, genetic researcher John Carpten, professor and chair of translational genomics at the Keck School of Medicine at USC, was studying patients with a strong family history of prostate cancer, which kills Black men at twice the rate of White men.

“I remember asking myself, ‘I wonder how many of these families are African American?'” he said.

That was hard to answer because racial and ethnic minorities have been underrepresented in research studies.

“If we’ve got 95% of the data coming from Whites, how can we say that we understand the full complexity of cancer when we know that the cancers disproportionately impact other groups?” Carpten said.

For Tomer, she told CBS News, “My new journey in life has been dealing with breast cancer.”

She is now spreading a message of cancer awareness, including a new tattoo that says it all: Get your dukes up.