Breast Cancer Rates in Black and White Women Now Equal

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Historically, black women have been more likely to be diagnosed with breast cancer when they were younger than 40 and more likely to die from breast cancer. But overall, black women were less likely to be diagnosed with breast cancer than white women. Now that difference is disappearing.

According to statistics from the American Cancer Society, rates of breast cancer are increasing among black women, while staying stable among white women. The rates of the disease among the two ethnicities now are about equal.

The report was published online on Oct. 29, 2015 by CA: A Cancer Journal for Clinicians. Read "Breast Cancer Statistics, 2015: Convergence of Incidence Rates Between Black and White Women.”

The information in the report came from the SEER database, a large registry of cancer cases from sources throughout the United States maintained by the National Institutes of Health.

About 231,840 new cases of invasive breast cancer are expected to be diagnosed in U.S. women in 2015. About 40,290 women are expected to die from breast cancer in 2015.

From 2008 to 2012, rates of breast cancer:

  • went up 0.4% per year among black women
  • went up 1.5% per year among Asian/Pacific Islander women
  • remained stable among white, Hispanic, and American Indian/Alaska Native women

In 2012, rates of breast cancer were about the same in black and white women, the first time this has happened.

"For a while we've seen the increase in black women and stable rates in white women," said Carol DeSantis, an epidemiologist with the American Cancer Society who led the study. "Even though we'd seen the trend," she said, "it's sort of shocking."

The report found that black women are still more likely to die from breast cancer than white women, and this difference has increased over time. By 2012, death rates were 42% higher in black women than white women.

Other statistics in the report:

  • More than 3.1 million U.S. women with a history of breast cancer were alive on Jan. 1, 2014 (the most recent information available).
  • Deaths from breast cancer have dropped 36% since 1989. This means that 249,000 more women are alive after a breast cancer diagnosis.
  • From 2003 to 2012, breast cancer death rates went down 1.8% per year in white women, 1.5% per year in Hispanic women, 1.4% in black women, and 1% in Asian/Pacific Islanders. Rates among American Indian/Alaska native women stayed the same.
  • Black women are more likely to die from breast cancer than any other ethnic group. Black women are still more likely to be diagnosed with later-stage disease than other women and have the lowest survival rates in each stage of diagnosis. The researchers said reasons for this are lack of regular screening; lack of follow-up after suspicious screening results; lack of access to timely, high-quality treatment; and a higher percentage of aggressive, harder-to-treat tumors.
  • The subtype of breast cancer diagnosed varies by ethnicity. Black women are more likely to be diagnosed with triple-negative disease, which means the cancer has no receptors for the hormones estrogen and progesterone, as well as no receptors for the HER2 protein. This limits the medicines that can be used to treat the cancer.
  • In 2013, 69% of women ages 45 and older said they had a mammogram within the past 2 years. Screening rates were lower for women with no insurance and for Hispanics and American Indian/Alaska natives.

It’s not clear why rates of breast cancer are going up among black women, as well as why a higher proportion of black women continue to die from breast cancer.

Most experts think that it’s likely to be a combination of factors. Rising obesity rates among black women, coupled with statistics showing that more black women are having fewer children and having children later in life could play a role. We also know that black women are less likely to participate in clinical trials testing new breast cancer treatments. Some doctors think that it’s possible that some medicines work differently or less effectively in black women.

Other risk factors are likely involved, DeSantis said in an interview with National Public Radio. "I really don't know if there are changes in black women more than in white women -- having fewer children, having them later in life. I'd like to look into it some more. There may be other risk factors changing as well."

Women of all ethnicities can take steps to keep their risk of breast cancer as low as it can be. If you’re a black woman, you may want to talk to your doctor about your risk of breast cancer, as well as about lifestyle choices you can make to lower that risk, including:

  • maintaining a healthy weight
  • exercising every day
  • limiting or avoiding alcohol
  • not smoking
  • eating a healthy diet that’s low in processed foods, sugar, and trans fats

To learn more about breast cancer risk and other options to keep your risk as low as it can be, visit the Lower Your Risk section.

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