Poorer Women Slower to See Dip in Breast Cancer Death Rates
By Denise Mann
WebMD Health News
Reviewed by Laura J. Martin, MD
Oct. 3, 2011 -- Fewer women are dying from breast cancer, largely because of advances in screening and treatment. Poorer women, however, are seeing a slower and later decline in their risk of dying from breast cancer, in part because they don't have as much access to these life-saving advances.
In 2008, 51.4% of poor women aged 40 and older had a screening mammogram in the past two years. By contrast, 72.8% of wealthier women had a mammogram in the past two years.
These are some of the findings from the American Cancer Society's Breast Cancer Facts & Figures 2011-2012 report. It appears in CA: A Cancer Journal for Clinicians in time for National Breast Cancer Awareness Month, which takes place every October.
In 2011, an estimated 230,480 women will be diagnosed with breast cancer, according to the new report. About 39,520 women will die from the disease in 2011. Beside skin cancer, breast cancer is the most common cancer seen among American women.
In the early 1990s and before, women who lived in affluent areas were most likely to die from breast cancer. Since then, these rates have been higher among women in poorer areas, where the decline in death rates began later and was slower. Overall, breast cancer death rates decreased 2.2% per year from 1990 to 2007.
Mammograms Can Save Lives
It's an issue of access to care and education, says researcher Carol DeSantis, MPH. She is an epidemiologist at the American Cancer Society (ACS) in Atlanta. "Poor women are less likely to get screening," she says.
The ACS recommends that women get yearly mammograms beginning at age 40. The U.S. Preventive Services Task Force set off a maelstrom of controversy when it stated that women could get mammograms every two years from age 50 to 74. The decision to start getting mammograms before age 50, the task force says, should be an individual one based on benefits vs. harms. Besides annual mammograms starting at age 40, the ACS also calls for a yearly breast exam by a doctor. Some women may also choose to do monthly breast self-exams.
"The most important thing that all women can do is get an annual screening mammogram to detect breast cancer in its earliest stage, when it is most treatable," DeSantis says. "It does save lives, and it is worthwhile for women beginning at age 40."
There are some risks associated with mammograms, though, including the fact that they could lead to unnecessary and anxiety-provoking testing.
Other breast cancer statistics highlighted in the new report, include:
- The rate of decline of dying from breast cancer from 1990 to 2007 was greater in women younger than 50 compared to older women, 3.2% per year vs. 2.0%, respectively.
- Trends in breast cancer death rates vary by state. There were declines in 36 states and the District of Columbia. These rates were unchanged in the remaining 14 states.
- Overall breast cancer rates are lower in African-American women than white women. But African-American women have higher rates of more advanced disease, are more likely to be diagnosed with larger breast tumors, and are more likely to die from breast cancer.
All Women at Risk for Breast Cancer
The overall news on the breast cancer front is good, DeSantis says. "We are still on decline, and I do think it is possible to continue to make progress."
Marisa Weiss, MD, is the president and founder of Breastcancer.org. She is also the director of Breast Radiation Oncology and Breast Health Outreach at Lankenau Hospital in Wynnewood, Pa., and a breast cancer survivor. "It's upsetting when anyone is diagnosed with breast cancer, and there is no question that the burden of the disease and the outcome continue to be worse in poor women," she says.
"We have major medical advances with great benefits that are underutilized," Weiss says. "The idea of getting a mammogram every year can fall off of the plate when a woman is over-committed and too busy, and then they think 'if they find something, how I will afford the treat it?'"
Women should make breast health a priority, she says.
All women are at risk for breast cancer. Family history is just part of it. Most women who are diagnosed with breast cancer have no significant family history of this disease. "Even the thin vegetarian yoga instructor with no family history can get breast cancer," she says.
"We are making great progress, but we still have a long way to go," Weiss tells WebMD. "Breast cancer is a very complex disease and we want to be able to prevent or cure all forms."
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SOURCES: Carol DeSantis, MPH, epidemiologist, American Cancer Society, Atlanta.Marisa Weiss, MD, president and founder, Breastcancer.org; director, Breast Radiation Oncology and Breast Health Outreach, Lankenau Hospital, Wynnewood, Pa.Desantis, C.CA Cancer, 2011. ©2011 WebMD, LLC. All Rights Reserved.