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OCTOBER 2006 IS
BREAST CANCER AWARENESS MONTH |
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In the United States,
breast cancer is the most common non-skin cancer and the second
leading cause of cancer-related deaths in women.1
The National Cancer Institute estimates that, based on current
rates, 13.2% of women born today will be diagnosed with breast
cancer at some time in their lives.2
Each year, a small number of men are also diagnosed with or die from
breast cancer .1 |
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EXAMPLES OF IMPORTANT HEALTH DISPARITIES |
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Racial and Ethnic |
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In 2002, the breast cancer
incidence rate was 1.2 times higher for non-Hispanic white women
(144.2 per 100,000) than for African American women (119.3 per
100,000).3
However, In 2003 the breast cancer death rate was 1.3 times higher
for African American women (34.0 per 100,000) than for non-Hispanic
white women (25.2 per 100,000), and 2.7 times higher for than for
Asian American women (12.6).4 |
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From 1995-2001, the breast
cancer 5-year survival rate was 1.2 times higher among white women
(89.5%) as among African American women (75.9%).5 |
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In 2003, non-Hispanic
white and non-Hispanic black women ages 40 and over were 1.1 times
more likely to have a mammogram (70.5%) than Hispanic/Latina women
(65.0%) and American Indian/Alaska Native women (63.1%), and 1.2
times more likely to have a mammogram than Asian American women
(57.6%).6 |
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Table 1: Breast
Cancer Incidence and Death Rates by Race |
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Incidence rate
per 100,000 population, 20037 |
Death rates
per 100,000
population, 20034 |
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Whites |
125.0 |
24.7 |
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African Americans |
116.0 |
34.0 |
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American Indians / Alaska
Natives |
N/A |
14.0 |
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Asian Americans and Pacific
Islanders |
83.7 |
12.6 |
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Hispanic/Latinos |
84.5 |
16.1 |
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Non-Hispanic Whites |
N/A |
25.2 |
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Disability |
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In 2003, 65% of women with
disabilities ages 40 and over had had a mammogram in the prior two
years.8 This compares to 70% of all women over age 40 who had a
mammogram in the 2003 (age-adjusted).6 |
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Income and Education |
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During
1997-1999, U.S. breast cancer mortality was 41% higher for
Hispanic/Latina women in high poverty areas* (19.0%) than those in
low poverty areas (13.5%).**
9 |
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During
1975-1999, SEER female breast cancer incidence rates were 31% higher in
lower poverty areas* (136.3 per 100,000 populations
vs. 103.9), with incidence rates increasing more rapidly
in lower poverty groups than in higher poverty groups.9 |
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The percent of women over 40 who reported receiving a mammogram in the last
year rose with education level among American women. Compared to
those with some college or more (75.1%), only 58.1% of those with no
high school diploma or GED had the screening test.6 |
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Women ages
40-64 with health insurance were 1.8 times more likely to have a
mammogram in 2003 compared to those without health insurance (75.1%
vs. 41.5%).6 |
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In 2003,
breast cancer incidence was somewhat higher among those with family
income of less than $20,000 per year (1.3%) and $35,000-54,999 per
year (1.3%) compared to other income brackets ($20K-$34,999: 1.1%;
$55K+: 1.0%).10 |
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Age |
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In 2003,
women ages 55-64 were 1.9 times more likely to die from breast
cancer (56.6 per 100,000) as women ages 45-54 (30.4 per 100,000),
and those ages 75-84 were 4.1 times more likely to die from breast
cancer (123.7 per 100,000) as those ages 45-54.11 |
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In 2003, the
percent of Americans ages 65-74 diagnosed with breast cancer (4.1)
was 3.2 times higher than those ages 45-64 years (1.3).10 |
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PROMISING INTERVENTION STRATEGIES |
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Racial and ethnic
minorities tend to receive lower-quality health care than white
women even when insurance status, income, age and severity of
conditions are comparable. Many of the differences in cancer
incidence and mortality rates among racial and ethnic groups may be
due to factors associated with social class rather than ethnicity.
Socioeconomic status, in particular, appears to play a major role in
differences in cancer incidence and mortality rates, risk factors
and screening prevalence among racial and ethnic minorities.12 |
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Minority groups’ access to
cancer care and clinical trials has been expanded to ensure that
people in these communities are provided the same quality, access,
and state-of-the-art technology that patients in major care centers
receive.13 |
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WHAT CDC IS DOING |
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CDC’s Division of Cancer
Prevention and Control engages in the following activities: |
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Monitoring: CDC
provides funding and assistance to help states, tribes/tribal
organizations, and territories collect data on cancer incidence and
deaths, cancer risk factors, and the use of cancer screening tests.
Public health professionals use the data to identify and track
cancer trends, strengthen cancer prevention and control activities,
and prioritize the use of resources. |
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Conducting Research and
Evaluation: CDC conducts and supports studies designed to help
the cancer community better understand the factors that increase
cancer risk, and identify opportunities to prevent cancer. CDC also
evaluates the feasibility and effectiveness of strategies designed
to prevent and control cancer. |
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Building Capacity and
Partnerships: CDC works with partners to translate research into
public health programs, practices, and services. To ensure that
innovations reach the people who most need them, CDC helps states,
tribes/tribal organizations, and territories build the capacity to
apply scientific advances to the development of strong cancer
control programs. |
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Educating: CDC
develops communication campaigns and materials designed to teach
health professionals, policy makers, the media, and the public about
cancer prevention and control.14 |
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PROGRAMS AND ACCOMPLISHMENTS |
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The
National Comprehensive Cancer Control Program is a collaborative
process through which a community and its partners pool resources to
promote cancer prevention, improve cancer detection, increase access
to health and social services, and reduce the burden of cancer.
These efforts will contribute to reducing cancer risk, detecting
cancers earlier, improving treatments, and enhancing survivorship
and quality of life for cancer patients.15 |
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CDC National Breast and Cervical Cancer Early Detection Program
(NBCCEDP)
provides access to critical breast and cervical cancer screening
services for underserved women in the United States, the District of
Columbia, 4 U.S. territories, and 13 American Indian/Alaska Native
organizations (16). Since 1991, the NBCCEDP has served more than
2.5 million women, provided more than 5.8 million screening
examinations, and diagnosed more than 22,000 breast cancers.
17 |
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CDC National Program of Cancer Registries (NPCR)
Data collected by state cancer registries enable public health
professionals to understand and address the cancer burden more
effectively. CDC provides support for states to maintain registries
that provide high-quality data.18 |
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REACH 2010 is a federal initiative which includes the goal of
eliminating racial and ethnic disparities in health by the year
2010. This goal is one of two goals that parallels the focus of
Healthy People 2010, which describes the nation's health objectives
for the decade. REACH 2010 is part of the national initiative to
eliminate disparities in health status experienced by racial and
ethnic minority populations in six priority areas, including breast
cancer.19 |
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Other breast
cancer-related projects include |
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Use of Mass Media by
African American Women; |
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Breast and Cervical Cancer
Screening in Never and Rarely Screened Women; |
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Data Linkage with the
Indian Health Service; |
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Racial Differences in Risk
Factors for Breast Cancer; and |
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Study Highlights Methods
and Messages for Reaching Diverse Populations.20 |
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NOTES |
* Defined as 20% or
higher of county population below the poverty level in 1990.
** Defined as <10% of county population
below the poverty level in 1990. |
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FOR MORE
INFORMATION |
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Centers for Disease Control and Prevention
(CDC) |
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National Center for Chronic Disease Prevention and Health Promotion
(NCCDPHP) |
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Cancer Prevention and Control (CPC) |
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The National Breast and Cervical Cancer Early Detection Program:
1991–2002 National Report |
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United States Cancer Statistics, 2002 Incidence and Mortality |
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Health Disparities: Minority Cancer Awareness |
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National Cancer Data |
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National Breast and
Cervical Cancer Early Detection Program (NBCCEDP) |
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Breast and
Cervical Cancer Screening Practices Among Hispanic and Non-Hispanic
Women Residing Near the United States–Mexico Border |
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National Center for Health Statistics (NCHS) |
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Cancer Fastats |
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Racial and Ethnic Approaches to Community Health (REACH) 2010
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Other Federal Government |
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National
Cancer Institute (NCI) Breast
Cancer Home Page |
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Breast Cancer Risk Assessment
Tool |
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Other Organizations |
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National Breast Cancer Awareness Month (NBCAM) |
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American
Cancer Society (ACS) |
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Breast Cancer Facts and Figures 2005-2006 |
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SOURCES |
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1. |
National Institutes of Health (NIH),
“A Snapshot of Breast Cancer,” 2005,
p. 1 |
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2. |
NIH, National Cancer Institute (NCI),
“Probability of Breast Cancer in American Women,”
2005, p. 1 |
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3. |
CDC, National Center for Health Statistics
(NCHS), Health United States,
2005, table 53 |
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4. |
CDC, NCHS, Health United States,
2005,
table 29 |
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5. |
CDC, NCHS, Health United States,
2005, table 54 |
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6. |
CDC, NCHS, Health United States,
2005, table 86 |
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7. |
National Cancer Institute (NCI), Surveillance,
Epidemiology, and End Results
(SEER) Program, Public-Use,
Nov 2005 |
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8. |
CDC, CDC Wonder,
Data2010 |
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9. |
NIH, NCI, United States Cancer Statistics:
2002 Incidence and Mortality,
p. 6 |
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10. |
CDC, NCHS, Summary Health Statistics for U.S.
Adults:
National Health Interview Survey,
2003 table 6 |
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11. |
CDC, NCHS, Health United States,
2004, table 40 |
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12. |
NIH, NCI,
“NCI Health Information Tip Sheet for Writers: Cancer Health
Disparities,”
2005 |
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13. |
CDC, Office of Minority Health (OMH),
“Eliminate Disparities
in Cancer Screening & Management,”
2005 |
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14. |
CDC,
About CDC Cancer Prevention and Control,
2006 |
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15. |
CDC, NCCDPHP,
Cancer Prevention and Control,
2005 |
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16. |
CDC, NCCDPHP,
“Health Disparities: Minority Cancer Awareness,” 2005 |
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17. |
CDC, NCCDPHP, The National
Breast and Cervical Cancer Early Detection Program,
2006 Fact Sheet |
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18. |
CDC,
National Program of Cancer Registries |
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19. |
CDC,
Racial and Ethnic Approaches to Community Health (REACH) 2010, 2005 |
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20. |
CDC,
Health Disparities in Cancer, Science and Research, 2006 |
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