A new study from the American Cancer Society finds that while breast cancer death rates are decreasing for white women in every U.S. state, for African American women, death rates are either flat or rising in at least half the states. The study finds breast cancer death rates among African American women are decreasing in only 11 of 37 states with sufficient numbers for analysis and in the District of Columbia. In the rest, death rates are either flat (24 states) or actually increasing (two states: Arkansas and Mississippi).
American Cancer Society researchers led by Carol DeSantis, MPH, analyzed mortality data from the National Center for Health Statistics (NCHS) for the years 1975 through 2004 by state and race. At the national level, death rates began to decline in 1990 for white women and in 1991 for African American women. But they decreased far slower in African American women.
As a result, the gap in death rates from breast cancer between African American and white women has increased substantially. In 1991, death rates among African American women were 18 percent higher compared to white women; by 2004, they were 36 percent higher. Although breast cancer death rates have decreased in both African American and white women in the U.S. as a whole, the study found death rates have increased or remained level for African American women in 26 states.
Access to and utilization of screening as well as regional variations in the quality and timeliness of treatment likely play important roles in the disparity, write the authors, and states should focus their cancer control efforts to increase health awareness within underserved communities and to ensure that all women have access to high-quality early detection and treatment services.
"We've known for some time that these disparities exist," said Otis W. Brawley, MD, chief medical officer of the American Cancer Society. "This new study helps us drill down to identify pockets of need. We need to ensure that we level the playing field for all women regardless of race, income level, or where they live."
The National Breast and Cervical Cancer Early Detection Program (NBCCEDP) is a federal program to help low-income women gain access to timely, high quality breast and cervical cancer screening; however in many states only a small percentage of the eligible women are receiving mammography. According to data from the program, the proportion of eligible women receiving a program-funded mammogram during 2002--2003 varied by state from 2 percent to 79 percent, with an average of 13 percent nationally.
State by state listing of breast cancer mortality trends in African American women are listed below.
- North Carolina
- Rhode Island
- South Carolina
- West Virginia
- New Jersey
- New York
- Washington DC
Journal article: "Temporal trends in breast cancer mortality by state and race," DeSantis C, Jemal A, Ward E, Thun MJ. Cancer Causes and Control. DOI 10.1007/s10552-008-9113-1
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