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A CUP OF HEALTH WITH CDC
Good News about Breast Cancer
Recent Decline in Breast Cancer Incidence Rates in the United States, 1999–2003
September 7, 2007

[Announcer] This podcast is presented by the Centers for Disease Control and Prevention. CDC – safer,
healthier people.

[Ana Benson] Welcome to A Cup of Health with CDC, a weekly broadcast of the
MMWR, the Morbidity and Mortality Weekly Report. I’m Ana Benson, filling in for your
host, Matthew Reynolds.

A diagnosis of breast cancer can be pretty frightening news for anyone. Many women
know someone who has had breast cancer and may also have a friend or relative who
has died as a result of breast cancer. Today, I’m going to be talking with Dr. Sherri
Stewart about a study she and her CDC colleagues recently completed. Dr. Stewart is
with CDC’s Division of Cancer Prevention. In this study, Dr. Stewart examines rates of
breast cancer diagnoses among women in the United States from 1999 to 2003.
Welcome to the show, Dr. Stewart.

[Dr. Stewart] Thank you, Ana. It’s a pleasure to be here.

[Ana Benson] Dr. Stewart, your report comes at time when breast cancer has been in
the news. When Elizabeth Edwards, wife of presidential candidate John Edwards,
recently announced that her breast cancer had returned, that put a very real face on this
diagnosis for many of us and provided a window into how this can affect the whole
family. What did your study tell you about the number of women affected by breast
cancer?

[Dr. Stewart] Well, in our study, we looked at more than a million cases of breast
cancer. These included different types of breast cancer, like invasive breast cancer.
This is where cancer cells have spread to other parts of the body. We also looked at in
situ breast cancer where cancer cells have not spread to nearby tissues or other parts
of the body. Some of the highlights of what we found were that rates of invasive breast
cancer have dropped every year from 1999 to 2003. The largest decrease was from
2002 to 2003 when we found a 6% decrease in the rates of invasive breast cancer. This
decrease was seen in all women over fifty and women from sixty to sixty-nine had the
largest decrease. During the same time, we found a significant decrease of in situ
cancers among women from fifty to eighty years old. We also found a decrease in
localized or early stage breast cancer. However, we did not see a significant decrease
in late stage breast cancer.

[Ana Benson] Interesting. Now, did you find the same decreases in breast cancer
across various ethnic and racial groups?

[Dr. Stewart] Yes, we found similar decreases. From 2002 to 2003, invasive breast
cancer rates dropped among white, black, Asian/Pacific Islander, and Hispanic women.
And actually, white women and Asian/Pacific Islander women had the largest decreases
in invasive breast cancer rates. For American Indian or Alaska Native women, the
invasive breast cancer rates remained about the same as in the past.

[Ana Benson] Now, the information you collected came from forty-one states in the
U.S. Did you find differences in breast cancer rates in specific states or regions of the
U.S.?

[Dr. Stewart] Yes we did. We saw significant decreases in breast cancer rates in 24 of
the 41 states included. We did not see increases in breast cancer rates in any particular
state and we also did not find any clear geographic patterns among the states’ rates of
breast cancer.

[Ana Benson] With your study revealing lower rates of breast cancer, I imagine you
and your colleagues gave some thought to possible explanations for these decreases.
Tell me, were you able to identify reasons why the rates of breast cancer were falling?

[Dr. Stewart] Well, Ana, it’s difficult to be certain, but we do have some ideas about
why we’re seeing a drop in breast cancer rates. Other studies in recent years have
shown that hormone replacement therapy causes an increased risk of breast cancer.
The findings from these other studies led many doctors to tell women to stop using
hormone replacement therapy because of this increased risk. Also, the number of
women being screened for breast cancer through mammograms has an impact on the
breast cancer rates. Recent studies have shown that about 1.1 million fewer women
were being screened for breast cancer in recent years. And so we think, therefore, that
maybe drops in breast cancer rates may be related to fewer women being treated with
hormone replacement therapy, or fewer women being screened for breast cancer, or
actually a combination of both factors.

[Ana Benson] Now, I’m sure there are a lot of people, women especially, who find
these studies really encouraging. Tell me, what will CDC be doing going forward?

[Dr. Stewart] Well, CDC will continue to study the rates of breast cancer, in part
through our National Program of Cancer Registries. And we’ll also continue to evaluate
the number of women who are going for screening mammograms. We’re actually in the
planning process for a public awareness program to raise awareness and increase the
number of women being screened. In order to continue to reduce breast cancer
mortality, CDC also provides low income women with access to mammograms through
a program called the National Breast and Cervical Cancer Early Detection Program. For
more information on this program, call 1-800-CDC-INFO or visit www.cdc.gov/cancer/
for a link. This program helps ensure access to timely, high quality breast cancer
screening and diagnostic services, and it increases the likelihood of the earliest possible
breast cancer diagnoses.

[Ana Benson] Thank you for taking the time to talk with us today, Dr. Stewart.

[Dr. Stewart] Thanks very much for inviting me, Ana.

[Ana Benson] That’s it for this week’s show. Don’t forget to join us next week. Until
then, be well. This is Ana Benson for A Cup of Health with CDC.

[Announcer] To access the most accurate and relevant health information that affects you, your family
and your community, please visit www.cdc.gov.