A new report from the American Cancer Society finds that deaths from breast cancer
in the United States continue to decline steadily. However, the decline
has been faster for women who live in more affluent areas. Women from
poor areas now have the highest rates of death from breast cancer.
“In general, progress in reducing breast cancer death rates is being
seen across races/ethnicities, socioeconomic status, and across the
U.S.,” said Otis W. Brawley, M.D., chief medical officer of the American
Cancer Society. “However, not all women have benefitted equally. Poor
women are now at greater risk for breast cancer death because of less
access to screening and better treatments. This continued disparity is
impeding real progress against breast cancer, and will require renewed
efforts to ensure that all women have access to high-quality prevention,
detection, and treatment services.”
The findings are published in Breast Cancer Facts & Figures 2011-2012 and in Breast Cancer Statistics, 2011 in CA: A Cancer Journal for Clinicians.
The report, published every two years since 1996, provides detailed
analyses of breast cancer trends and presents information on known risk
factors for the disease, factors that influence survival, the latest
data on prevention, early detection, treatment, and ongoing research.
Steady Decline
Breast
cancer death rates have declined steadily since 1990. The drop has been
larger among women under 50 (3.2% per year) than among women over 50
(2.0% per year).
An estimated 230,480 women will be diagnosed with
invasive breast cancer in 2011. Breast cancer is the most common cancer
among women in the United States, after skin cancer. Breast cancer
accounts for nearly 1 in 3 cancers diagnosed in women. Men can get breast cancer too,
but it is much rarer and accounts for only 1% of breast cancer cases in
the United States. An estimated 39,520 women are expected to die from
the disease in 2011.
In January 2008, the latest year for which
statistics are available, approximately 2.6 million women living in the
U.S. had a history of breast cancer. More than half of them were
diagnosed less than 10 years earlier. Most of them were cancer-free,
while others still had evidence of cancer and may have been undergoing
treatment.
Race and Socioeconomic Factors
White women get
breast cancer at a higher rate than African-American women, but
African-American women are more likely to get breast cancer before they
are 40, and are more likely to die from it at any age. This is likely
because the cancer is more advanced when it is found in African American
women, and because survival at every cancer stage is worse among
African American women. Incidence and death rates for breast cancer are
lower among women of other racial and ethnic groups.
Poverty and a
lack of health insurance are also associated with lower breast cancer
survival. In 2008, 51.4% of poor women ages 40 and older had a screening
mammogram in the past 2 years compared to 72.8% of women who were not
poor. The presence of additional illnesses, unequal access to medical
care, and disparities in treatment also likely contributed to
differences in breast cancer survival.
Death rates were highest
among women who lived in affluent areas until the early 1990s, but since
that time rates have been higher among women in poorer areas because
the decline in their death rates began later and was slower.
Differences Among States
Trends
in breast cancer death rates also vary by state. During 1998-2007,
death rates declined in 36 states and the District of Columbia, but
remained relatively unchanged in the remaining 14 states (Alabama,
Alaska, Arkansas, Hawaii, Louisiana, Mississippi, Missouri, Montana, New
Mexico, Oklahoma, South Dakota, Utah, Vermont, and Wyoming). The lack
of a decline in these states is likely related to differences in the
availability and quality of mammogram screening, as well as state
differences in racial and socioeconomic composition.
Risk Factors
Breast
cancer incidence and death rates generally increase with age.
Ninety-five percent of new cases and 97% of breast cancer deaths
occurred in women 40 years old and older.
Obese breast cancer patients have about a 30% higher risk
of death compared to those who maintain a healthy weight. Research also
suggests that exercise during and after treatment improves outcomes.
Women
with a family history of breast cancer, especially in a mother, sister,
daughter, father or brother, are at increased risk of developing breast
cancer.
To find breast cancer early, when treatments are more likely to be successful, the American Cancer Society recommends
women 40 and older have a mammogram and clinical breast exam every
year, and younger women have clinical breast exams periodically as well.
By Stacy Simon
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