American Cancer Society Report Finds Rising Rates of Breast Cancer Among African American Women, Especially in Southern States
Although white women have historically had higher incidence rates of breast cancer than African American women, a new report by the American Cancer Society (ACS) finds that, in 2012, the rates converged. The incidence rates were significantly higher in black women than in white women in seven states, most of which are located in the South, including Alabama, Kentucky, Louisiana, Mississippi, Missouri, Oklahoma, and Tennessee. The mortality black-white disparity is also on the rise, with death rates 42% higher in black women than white women. According to the report, widening racial disparities in breast cancer mortality are likely to continue. The findings are published in CA: A Cancer Journal for Clinicians and in Breast Cancer Facts & Figures 2015-2016.
Study Methodology
The study authors obtained data on incidence trends, probabilities of developing cancer, and cause-specific survival from the Surveillance, Epidemiology, and End Results (SEER) Program of the National Cancer Institute. They analyzed incidence rates by race/ethnicity, stage at diagnosis, and the distribution of breast cancer cases by hormone receptor and HER2 status obtained through data from the North American Association of Central Cancer Registries.
Study Findings
According to the ACS report, about 231,840 new cases of invasive breast cancer and 40,290 deaths from breast cancer are expected to occur among women in the United States in 2015. From 2008 to 2012, breast cancer incidence rates increased 0.4% per year in black women and 1.5% per year among Asian/Pacific Islanders, while they remained stable among white women, Hispanics, and American Indian/Alaska Natives. By 2012, the rate at which black women were diagnosed with breast cancer equaled the rate at which white women were diagnosed. Other key findings include:
- Overall, breast cancer mortality rates decreased by 36% from 1989 to 2012, averting 249,000 breast cancer deaths in this period.
- The mortality disparity between black and white women continues to widen, with death rates 42% higher in black women than white women, and this trend is expected to continue. The difference likely reflects a combination of biologic and nonbiologic factors, including differences in stage at diagnosis, obesity and comorbidities, tumor characteristics, as well as access, adherence, and response to treatment. Other factors may include differences in the quality of mammography screening and delayed follow-up for abnormal mammography findings.
- Black women are more likely than other racial/ethnic groups to be diagnosed at later stages and have the lowest survival at each stage of diagnosis. They are also more likely to be diagnosed with triple-negative breast cancer, an aggressive subtype that is linked to poorer survival.
Prevention and Early Detection Strategies
According to the ACS report, one-third of breast cancers could be prevented through healthy behaviors, including maintaining a healthy body weight, engaging in regular physical activity, and not smoking or drinking alcohol. In addition, a review of studies by the Collaborative Group on Hormonal Factors in Breast Cancer showed that the risk of breast cancer is reduced by 4% for every 12 months of breastfeeding.
The study authors said that clinicians should encourage their patients to have regular screening mammography. New ACS guidelines for average-risk women call for annual screenings for women ages 45 to 54; and biennial screenings for women 55 and older.
“It is also important that patients at high risk of breast cancer are identified and offered appropriate screening and follow-up. In addition, increased efforts are required to ensure that all segments of the population receive consistent follow-up of abnormal results, prompt diagnosis, and the delivery of high-quality treatment for breast cancer,” concluded the study’s authors.
Carol E. DeSantis, MPH, of the American Cancer Society, is the corresponding author of this study.
The study authors reported no conflicts of interest.
The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.
