ACS: Poor women less likely to screen for, more likely to die from breast cancer

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The burden of breast cancer deaths has shifted to poor women, according to “Breast Cancer Statistics, 2011,” a report issued by the American Cancer Society (ACS). Poor women are less likely than non-poor women to undergo screening mammography, which may be a factor in the disparate death rates, according to the authors.

The report found a slower and later decline in breast cancer death rates among women in poor areas, which has resulted in a shift in the highest breast cancer death rates from women residing in more affluent areas to those in poor areas.

In 2008, 51.4 percent of poor women ages 40 and older had undergone a screening mammogram in the past two years compared to 72.8 percent of non-poor women.

Analyses by county level poverty rates showed that death rates were highest among women residing in affluent areas until the early 1990s. Since that time, however, rates have been higher among women in poorer areas because the death rates declined later and more slowly among that group compared with women in affluent areas.

"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, MD, chief medical officer of the ACS. "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."

"Breast Cancer Statistics, 2011" appears in CA: A Cancer Journal for Clinicians and provides detailed analyses of breast cancer trends, presents information on known factors that influence risk and survival and provides data on prevention, early detection, treatment and ongoing research.

The report also found:

  • Breast cancer mortality rates have declined steadily since 1990, with the drop in mortality larger among women under 50 (3.2 percent per year) than among women 50 and older (2 percent per year).
  • In 2011, an estimated 230,480 women will be diagnosed with breast cancer. Excluding cancers of the skin, breast cancer is the most common cancer among women in the U.S., accounting for nearly one in three cancers diagnosed.
  • An estimated 39,520 women are expected to die from the disease in 2011. Only lung cancer accounts for more cancer deaths in women.
  • In January 2008 (the latest year for which figures are available), approximately 2.6 million women living in the U.S. had a history of breast cancer, more than half of whom 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.
  • From 2004 to 2008, the average annual female breast cancer incidence rate was highest in non-Hispanic white women (125.4 cases per 100,000 females) and lowest for Asian Americans/Pacific Islanders (84.9 cases). During this time period, breast cancer incidence rates were stable among all racial/ethnic groups.
  • Although overall breast cancer incidence rates are lower in African American than white women, African American women have higher rates of distant stage disease; are more likely to be diagnosed with larger tumors; and are more likely to die from the disease.
  • From 1998 to 2007, female breast cancer death rates declined annually by 1.9 percent in Hispanics/Latinas, 1.8 percent in non-Hispanic whites, 1.6 percent in African Americans, and 0.8 percent in Asian Americans/Pacific Islanders. Death rates have remained unchanged among American Indians/Alaska Natives.

Trends in breast cancer death rates vary by state. During 1998 to 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 variations in the prevalence and quality of mammography screening, as well as state differences in racial and socioeconomic composition, according to the ACS.

To view "Breast Cancer Statistics 2011," click here.