When all cancers are taken into consideration, breast cancer has the highest rate of occurrence in women in the United States (see figure 1). These rates have been true since the mid-1950s. Only recently has lung cancer surpassed breast cancer in mortality rate in the United States . However, women in Utah still have a higher mortality rate due to breast cancer, rather than lung cancer , most likely due to Utah’s low rate of smoking tobacco. Utah is ranked the fifth lowest state for deaths due to invasive breast cancer . Utah’s breast cancer incidence and mortality rates have remained relatively stable over the past decade (see Figure 2).
A recently published study concluded that breast cancer incidence rates have dropped by approximately 7% from 2002 to 2003. This decrease is the largest decline seen in over a decade. The study offered the decline of hormone replacement therapy in post-menopausal women as the major contributing factor. The decline in incidence rate of breast cancer was even higher among women aged 50 and older; their rate dropped by 15% during the same time period. Hormone replacement therapy usage has dropped approximately 30% since the Women’s Health Initiative study, published in 2002, concluded that hormone replacement therapy increased women’s risk of developing breast cancer, among a plethora of other health problems .
In the United States, mortality rates due to breast cancer have decreased by an average of 2.3% per year from 1990-2002 . This reduction is most likely due to increased screening mammograms and detection of breast cancer at an earlier stage in the disease process. Women in the U.S. have a 12.67% lifetime risk of developing breast cancer . Lifetime risk assessments refer to the risk of developing a disease during one’s lifetime.
When race and ethnicity are considered, white women have the highest incidence rate of breast cancer when age groups are pooled. Black women have significantly higher incidence rates of breast cancer before age 40 compared to white women. After age 50, black women have a significantly lower incidence rate when compared with white women. Black women are more likely to be diagnosed with breast cancer at a more advanced stage of disease than white women and, therefore, are more likely to die from breast cancer. These differences are likely due to disparities in insurance coverage and socioeconomic status. American Indian women and Asian/ Pacific Islander women have lower incidence rates of breast cancer than white women. Hispanic women have a lower incidence rate of breast cancer than non-Hispanic women .
Known risk factors for breast cancer include, family history, genetics (BRCA1 and 2 which account for approximately 5-10% of breast cancer cases), long menstrual time (early menstrual start or late menopause), obesity, hormone replacement therapy, oral contraceptive use, never having children, and having a first birth after age thirty .
Mammography is the first line for early detection. The American Cancer Society recommends that women aged 40 and older receive mammograms every one to two years. Once women are 50 and older, annual mammograms are recommended. Younger women should perform self-examinations monthly and get regular examinations by a health care provider. Maintaining a healthy body weight, breast feeding, and maintaining an active lifestyle may help to reduce the risk of developing breast cancer .
- American Cancer Society. Available Online at http://www.cancer.org. Retrieved on Sep 24, 2006.
- Utah’s Indicator-Based Information System for Public Health: Breast Cancer Incidence, Breast Cancer Mortality, Breast Cancer Screening Outcomes. Available Online at http://ibis.health.utah.gov. Retrieved on Oct 11, 2006.
- MD Anderson. Available Online at http://www.mdanderson.org. Retrieved on Dec 15, 2006.
- Center for Disease Control. Available Online at http://cdc.wonder.org. Retrieved on Sep 24, 2006.
- National Cancer Institute. Available Online at http://cancer.gov. Retrieved on Oct 13, 2006.
- Joslyn, SA; Foote, ML; Nasseri, K; Coughlin, SS; Howe, HL. (2005). Racial and ethnic disparities in breast cancer rates by age. NAACCR Breast Cancer Project. Breast Cancer Research and Treatment, 92(2): 97-105.