BREAST CANCER MORTALITY RATES ARE DECLINING in the United States in recent years. However, the incidence rates are slowly increasing, and we have a persistent racial disparity in breast cancer mortality.
A new report published earlier this month in CA: A Cancer Journal for Clinicians offers both good and troubling news about breast cancer in the United States. The report is an annual one from the American Cancer Society.
Today we explore how breast cancer incidence has increased in most of the past four decades. We will then turn to more positive news about breast cancer mortality declining (although at a slower pace than ten to twenty years ago). Finally, I want to explore some bad news about how certain populations have higher breast cancer death rates than others.
Breast cancer across the globe
Researchers from the International Agency for Research on Cancer (IARC) and partner institutions provide a global overview of the burden of breast cancer in 2020 and estimate the impact this disease will have in 2040.
The study authors believe that by 2040, the breast cancer burden will increase to more than three million new cases annually, an increase of 40 percent. This disease burden will translate to over one million deaths annually or 50 percent.
Breast cancer incidence is highest in regions that are better off economically, but transitioning countries have a disproportionate share of breast cancer deaths.
Here are the 2020 breast cancer incidence rates and deaths by age 74 for women from selected regions:
- Africa. Incidence 3.6 to 5.4% Deaths 1.7 to 2.5%
- The Caribbean. Incidence 5.5% Deaths 2%
- Central America. Incidence 4.2% Deaths 1.2%
- South America. Incidence 5.4% Deaths 1.5%
- North America. Incidence 9.7% Deaths 1.4%
- East Asia. Incidence 4.6% Deaths 1.1%
- China. Incidence 4.2% Deaths 1.2%
- SE Asia. Incidence 4.5% Deaths 1.7%
- South Central Asia. Incidence 2.9% Deaths 1.5%
- India. Incidence 2.8% Deaths 1.5%
- Western Asia. Incidence 5% Deaths 1.7%
- Central/Eastern Europe. Incidence 6.3% Deaths 1.8%
- Northern Europe. Incidence 9.4% Deaths 1.5%
- Southern Europe. Incidence 8.5% Deaths 1.5%
- Western Europe. Incidence 9.7% Deaths 1.7%
- Australia and New Zealand. Incidence 10.4% Deaths 1.3%
- Worldwide. Incidence 5.2% Deaths 1.5%
Nearly one in four breast cancer cases occurred in Eastern Asia, followed by Northern America (12.5 percent), South-Central Asia (11 percent), and Western Europe (7.5 percent).
Nearly half of all global breast cancer deaths occurred in Eastern, South Central, and South-Eastern Asia combined, and North America (7.1 percent) and Western Europe (6.4 percent) ranked numbers five and six for the number of deaths.
While 8.3 percent of all breast cancer cases occurred in Africa, the continent’s share of breast cancer deaths was considerably higher (12.5 percent of the global deaths).
Over seven in 10 new breast cancer cases (and over eight in 10 deaths) are among women aged 50 or older.
Breast cancer incidence is rising in the USA.
Breast cancer is common in the United States. As of January 1, 2022, we had an estimated 4.1 million women with a breast cancer history.
Of these women with a history of breast cancer, four percent live with metastatic disease — cancer has spread to distant organs such as the bones, lungs, liver, or brain. Looking more specifically at those with metastatic disease, over half had originally been diagnosed with non-metastatic breast cancer.
Breast cancer incidence rates in the United States have increased in the past forty years. First, the rate increased by 0.5 percent annually from 2010 through 2019. Most of the increase appeared to be associated with localized and hormone receptor-positive disease.
The good news? There has been a steady drop in breast cancer deaths since a peak in 1989. Unfortunately, the American Cancer Society adds that the pace has slowed in recent years (from 1.9 percent annually from 2002 to 2011 to 1.3 percent from 2011 to 2020).
The death rate declined for all racial and ethnic groups (except Native Americans and Alaska Natives). But we still have this disturbing racial disparity:
The death rate was 40 percent higher in Black women overall and double in adult women younger than 50 years. For every stage and molecular subtype of disease (except stage I), Black women had the lowest five-year relative survival of any racial/ethnic group.
We must do better.
One study author believes this:
“The slow decline in breast cancer mortality during the most recent period partly reflects stagnant screening uptake and suboptimal receipt of timely and high-quality treatment.”
We must do better. Thank you for joining me in this breast cancer incidence and mortality look. Oh, one more thing: