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Breast cancer trends of black women compared with white women.

Abstract

OBJECTIVE

To investigate why breast cancer mortality rates have decreased in the 1990's for white women but not for black women.

DESIGN

Racial differences in breast cancer incidence, survival, and mortality rates were examined using regression methods and age-period-cohort models.

SETTING

United States breast cancer mortality rates from 1970 through 1995, breast cancer incidence rates from 1980 through 1995, and 3-year survival rates from 1980 through 1993. The incidence and survival data are from the Surveillance, Epidemiology, and End Results Program, representing 11% of the US population, of the National Cancer Institute, Bethesda, Md.

RESULTS

For both white and black women aged 30 to 39 years, breast cancer mortality rates began decreasing in 1987. For white women aged 40 to 79 years, breast cancer mortality rates declined after 1989, and for black women aged 40 to 69 years, mortality rates ceased increasing in the middle to late 1980s. Birth cohort trends were similar by race, but calendar period trends and survival rates differed.

CONCLUSIONS

Declines in mortality rates in women younger than 40 years reflect a favorable birth cohort trend for women born after 1948 and likely reflect changes in risk factors. The increased early detection of breast cancer by mammography and improvements in breast cancer treatment appear to be contributing to the improving mortality trends in older women, although black women appear to have benefited less than white women from early detection and treatment advances. In addition, substantial increases in survival rates for white women with regional disease have contributed to their declining mortality rates and likely reflect an increasing use of beneficial adjuvant therapy.

Authors+Show Affiliations

,

Office of Special Populations Research, National Cancer Institute, Bethesda, Md., USA. kc10d@nih.gov

,

Source

MeSH

Adult
African Americans
Aged
Aged, 80 and over
Breast Neoplasms
European Continental Ancestry Group
Female
Humans
Incidence
Middle Aged
Mortality
Regression Analysis
United States

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

10575392

Citation

Chu, K C., et al. "Breast Cancer Trends of Black Women Compared With White Women." Archives of Family Medicine, vol. 8, no. 6, 1999, pp. 521-8.
Chu KC, Tarone RE, Brawley OW. Breast cancer trends of black women compared with white women. Arch Fam Med. 1999;8(6):521-8.
Chu, K. C., Tarone, R. E., & Brawley, O. W. (1999). Breast cancer trends of black women compared with white women. Archives of Family Medicine, 8(6), pp. 521-8.
Chu KC, Tarone RE, Brawley OW. Breast Cancer Trends of Black Women Compared With White Women. Arch Fam Med. 1999;8(6):521-8. PubMed PMID: 10575392.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Breast cancer trends of black women compared with white women. AU - Chu,K C, AU - Tarone,R E, AU - Brawley,O W, PY - 1999/11/27/pubmed PY - 1999/11/27/medline PY - 1999/11/27/entrez SP - 521 EP - 8 JF - Archives of family medicine JO - Arch Fam Med VL - 8 IS - 6 N2 - OBJECTIVE: To investigate why breast cancer mortality rates have decreased in the 1990's for white women but not for black women. DESIGN: Racial differences in breast cancer incidence, survival, and mortality rates were examined using regression methods and age-period-cohort models. SETTING: United States breast cancer mortality rates from 1970 through 1995, breast cancer incidence rates from 1980 through 1995, and 3-year survival rates from 1980 through 1993. The incidence and survival data are from the Surveillance, Epidemiology, and End Results Program, representing 11% of the US population, of the National Cancer Institute, Bethesda, Md. RESULTS: For both white and black women aged 30 to 39 years, breast cancer mortality rates began decreasing in 1987. For white women aged 40 to 79 years, breast cancer mortality rates declined after 1989, and for black women aged 40 to 69 years, mortality rates ceased increasing in the middle to late 1980s. Birth cohort trends were similar by race, but calendar period trends and survival rates differed. CONCLUSIONS: Declines in mortality rates in women younger than 40 years reflect a favorable birth cohort trend for women born after 1948 and likely reflect changes in risk factors. The increased early detection of breast cancer by mammography and improvements in breast cancer treatment appear to be contributing to the improving mortality trends in older women, although black women appear to have benefited less than white women from early detection and treatment advances. In addition, substantial increases in survival rates for white women with regional disease have contributed to their declining mortality rates and likely reflect an increasing use of beneficial adjuvant therapy. SN - 1063-3987 UR - https://www.unboundmedicine.com/medline/citation/10575392/Breast_cancer_trends_of_black_women_compared_with_white_women_ L2 - http://www.diseaseinfosearch.org/result/960 DB - PRIME DP - Unbound Medicine ER -