A new report by the American Cancer Society (ACS) shows that in the US, the overall rate of deaths from breast cancer in women continues to fall by around 2 per cent a year, a trend that started in 1990. However stark racial disparities within this figure continue to grow.
The ACS produce the report, in this case titled Breast Cancer Facts and Figures 2007-2008, every other year. It suggests that this downward trend, which is described as a “winning streak” is due mostly to advances in early detection and treatment.
However, the advances have not been the same for all races. The cancer death rate for white and Hispanic/Latina women fell by 2.4 per cent between 1995 and 2004, but over the same period fell by only 1.6 per cent for African-American women, and did not change at all for Asian American/Pacific Islanders or American Indian/Alaskan Native women.
The report also shows a decline in the rate of breast cancer incidence, the rate of new cases occurring every year, but cautions that this could be due to fewer women going for mammograms.
Chief Medical Officer of the ACS, Dr Harmon J Eyre, said the steady decrease each year is thanks to “increased efforts at prevention, better methods of detecting cancer early, and treatment advances”.
American women today are less likely to die of breast cancer than they have been in decades, said Harmon in a statement from the ACS.
However, this news is better for some groups than others, continued Eyre:
“Perhaps most troubling is the striking divergence in long-term mortality trends seen between African-American and white females that began in the early 1980s and that by 2004 had led to death rates being 36 per cent higher in African-American women.”
The report also shows that in the US:
- 178,480 new cases of invasive breast are expected to be diagnosed in 2007.
- 40,460 deaths from breast cancer are expected to be recorded, a rate superseded only by lung cancer, in women.
- About 2.4 million women live with a history of breast cancer (estimated figure is for 2004).
- 1 in 4 cancers in women is breast cancer.
- Between 1990 and 2004 the death rate from breast cancer went down by 2.2 per cent a year on average.
- This rate was significantly lower for younger women.
- Among white women the new breast cancer diagonses fell by 3.7 per cent a year during 2001 to 2004.
- During this period there was also a drop in the use of mammograms and hormone replacement therapy (HRT) by white women.
- During this period there was no significant change in breast cancer incidence among African-American women, among whom the mammogram and HRT use was unchanged.
- For women aged 50 and over, since 2001 there has been a steep reduction of 4.8 per cent a year in incidence rates.
- For women under 50, incidence rates have stayed the same since 1986.
- Slince the year 2000, incidence rates of smaller tumours has fallen by 3.8 per cent a year.
- The incidence rate of larger tumours, over 5.0 cm in size, on the other hand, has gone up by 1.7 per cent a year since 1992.
- Larger tumour size at diagnosis is linked to lower survival rates and both trends could be linked to increased obesity among postmenopausal women, use of HRT, or both.
The report also mentions the major risk factors for breast cancer that women can do something about themselves. For example, keeping control of weight; obesity increases the risk of postmenopausal (but not premenopausal) breast cancer. Gaining weight in adulthood does also.
Two other risk factors than women can do something about themselves include alcohol and exercise.
Women who have only 2 alcoholic drinks a day have a 21 per cent less chance of breast cancer, and women who exercise vigorously for 45 to 60 minutes 5 days or more a week can also lower their breast cancer risk. And for postmenopausal women, any amount of regular exercise reduces the risk of breast cancer.
Groundbreaking advances in breast cancer research, such as those looking at chemoprevention and “rational therapeutic” drugs tailored to individual patients and tumours are also mentioned in the ACS report.
The report also describes investigative trials such as the Sister Study that is looking for 50,000 cancer-free women who have a sister with a history of breast cancer. The study will track the women for 10 years and collect data on their genes, lifestyle and environment and will examine the link between these factors and breast cancer risk.
Chief Executive Officer of the ACS, Dr John R Seffrin, said:
“Taken together, this report highlights the remarkable gains we’ve made in the fight against breast cancer.”
“But”, he added, “it also puts into focus the challenge before us: to close the gap so all Americans can reap the benefits equally, and to ensure that no American woman faces an increased risk of dying from breast cancer because of her race or ethnicity or because of lack of access to quality care.”
Written by: Catharine Paddock