Trends in breast cancer by race and ethnicity - Clinical Briefs - Brief Article

Author: Carrie Morantz, Brian Torrey
Date: March 1, 2004

Although breast cancer rates have increased among women of all races since the early 1980s, mortality rates from breast cancer have decreased in the past decade, according to data from the American Cancer Society. "Trends in Breast Cancer by Race and Ethnicity" appears in the November/ December 2003 issue of CA: A Cancer Journal for Clinicians.

Approximately 211,300 new cases of breast cancer were expected to be diagnosed in 2003, mainly in white women. The annual age-adjusted incidence rate from 1996 to 2000 was 140.8 cases per 100,000 persons in white women, 121.7 per 100,000 in blacks, 97.2 per 100,000 in Asian Americans and Pacific Islanders, 89.8 per 100,000 in Hispanics, and 58 per 100,000 in American Indians and Alaska Natives. The increasing rate in white women predominantly involves small (i.e., 2 cm or smaller) and localized-stage tumors. Black women are more likely to be diagnosed with large tumors and distant-stage disease; the proportion of disease diagnosed at an advanced stage and with larger tumors is greater in all minorities than in white women.

The prevalence of several established risk factors differs across racial and ethnic subpopulations and may contribute to the higher incidence rates in whites compared with other racial and ethnic groups. These include differences in underlying reproductive risk factors (older age at first birth), use of hormone therapy, and access to and use of screening. White women tend to have delayed child bearing and more commonly use hormone therapy. Mammography use also has been historically higher in white women, although rates have become comparable in the most recent survey years.

Mortality rates have decreased by 2.5 percent per year in white women since 1990 and by 1 percent per year in black women since 1991. The disparity in mortality rates between white and black women increased progressively since 1980; by 2000, the age-standardized mortality rate was 32 percent higher in black women.

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