Carol E. Desantis
Breast cancer death rates in the United States declined by 39% between 1989 and 2015, according to data released today by the American Cancer Society.
In addition, although breast cancer death rates nationwide remain higher among black women than white women, the mortality rates for the two groups now are statistically equivalent in several states.
“A large body of research suggests that the black-white breast cancer disparity results from a complex interaction of biologic and nonbiologic factors, including differences in stage at diagnosis, ... obesity, other health issues [and] tumor characteristics, particularly a higher rate of triple-negative cancer,” Carol E. Desantis, MPH, director of breast and gynecological cancer surveillance for the American Cancer Society, said in a press release. “But the substantial geographic variation in breast cancer death rates confirms the role of social and structural factors, and the closing disparity in several states indicates that increasing access to health care to low-income populations can further progress the elimination of breast cancer disparities.”
Desantis and colleagues used SEER and National Program of Cancer Registries data to identify trends in breast cancer incidence, mortality, survival and screening over time, as well as to project the number of new breast cancer cases for 2017.
They determined 252,710 new cases of invasive breast cancer will be diagnosed among U.S. women this year, and 40,610 breast cancer deaths will occur.
Results showed breast cancer incidence rates between 2005 and 2014 remained stable among non-Hispanic white women and American Indian/Alaska Native women.
However, rates increased among Asian/Pacific Islander women (1.7% per year), non-Hispanic black women (0.4% per year) and Hispanic women (0.3% per year). Greater incidence of hormone receptor-positive breast cancers contributed to those increases.
Overall, breast cancer deaths declined by 39% from 1989 to 2015. The reduction equates to an estimated 322,600 breast cancer deaths averted during the 26-year period.
From 2006 to 2015, death rates declined for all racial/ethnic groups.
Disparities still persist, however.
From 2010 through 2014, overall breast cancer incidence was about 2% higher among non-Hispanic white women (128.7 per 100,000) than non-Hispanic black women (125.5 per 100,000). However, the breast cancer death rate during that period was 42% higher among non-Hispanic black women than non-Hispanic white women (29.5 per 100,000 vs. 20.8 per 100,000).
In 2015, non-Hispanic black women demonstrated considerably higher breast cancer mortality rates than non-Hispanic white women (mortality rate ratio [MRR] = 1.39; 95% CI, 1.35-1.43).
When researchers examined disparities by state, they determined excess death rates among black women ranged from 20% in Nevada (MRR = 1.2; 95% CI, 1.01-1.42) to 66% in Louisiana (MRR = 1.66; 95% CI, 1.54-1.79).
“Notably, breast cancer death rates were not significantly different in non-Hispanic black [women] and non-Hispanic white women in seven states, perhaps reflecting an elimination of disparities and/or a lack of statistical power,” Desantis and colleagues wrote. “Improving access to care for all populations could eliminate the racial disparity in breast cancer mortality and accelerate the reduction in deaths from this malignancy nationwide.” – by Mark Leiser
Disclosures: The authors report no relevant financial disclosures.