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Persons using assistive technology might not be able to fully access information in this file. For assistance, please send e-mail to: mmwrq@cdc.gov. Type 508 Accommodation and the title of the report in the subject line of e-mail. Breast Cancer Incidence and Mortality -- United States, 1992Breast cancer is the most commonly diagnosed nondermatologic cancer and the second leading cause of cancer-related deaths among women in the United States (1-3). In 1996, a total of 184,300 new cases of and 44,300 deaths from invasive breast cancer are projected among women (3). To assess trends in incidence and death rates for breast cancer among U.S. women, CDC analyzed national incidence data from the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) program (2) and death-certificate data from CDC's National Center for Health Statistics (NCHS) (4). This report presents incidence and death rates for breast cancer for 1992 (the most recent year for which SEER data were available) and summarizes trends in these rates for 1973-1992. Overall, these findings indicate that incidence rates for invasive breast cancer increased among women during 1973-1987 and stabilized during 1988-1992, while mortality rates remained stable during 1973-1988 and decreased during 1989-1992. The incidence rate of breast cancer in the United States is estimated by using aggregate data reported by the SEER program, which includes a nonrandom sample of approximately 14% of the U.S. population (2,5). Based on 1990 data from the Bureau of the Census, the demographic characteristics of persons included in SEER is representative of the total U.S. population for whites and blacks; in addition, persons included in SEER reflect the percentage of persons among the total U.S. population living below the poverty level * and the percentage of adults who graduated from high school (5). However, a higher proportion of persons included in SEER resided in urban areas (5). This analysis includes all cases of invasive breast cancer (International Classification of Diseases, for Oncology, codes C50.0-C50.9) registered in SEER. Annual incidence rates were computed for 1973-1992, and race- and age-specific average annual incidence rates were computed for the combined years of 1988-1992. Decedents for which the underlying cause of death was breast cancer (International Classification of Diseases, Adapted, Ninth Revision, codes 174.0-174.9) were identified from public-use mortality data tapes (4). Annual death rates were computed for 1973-1992, and race-specific average annual death rates by age and by state were computed for the combined years of 1988-1992. Denominators for annual incidence and death rate calculations were derived from U.S. census population estimates. Rates were directly standardized to the age distribution of the 1970 U.S. population using 5-year age groupings. Data are presented only for whites and blacks because numbers for other racial/ethnic groups were too small for meaningful analysis. Breast Cancer Incidence In 1992, the overall age-adjusted incidence rate for breast cancer was 110.6 per 100,000 women. The rate for white women (113.1) was higher than that for black women (101.0). During 1973-1992, the overall incidence rate increased from 82.5 to 110.6: rates increased steadily during 1973-1987, and stabilized during 1988-1992 (Figure_1). During 1988-1992, incidence rates increased directly with age until age 75-79 years for whites and age 80-84 years for blacks (2); the rates for whites and blacks were similar for women aged less than 45 years, but for women aged greater than or equal to 45 years, the rate was higher for whites than for blacks. During 1973-1992, race-specific rates varied: for white women, the age-adjusted rate increased 34% (from 84.3 to 113.1) and, for black women, increased 47% (from 68.7 to 101.0) (2). Breast Cancer Mortality In 1992, a total of 43,063 U.S. women died from breast cancer. The death rate was 26.2 per 100,000 women. During 1973-1992, the overall death rate varied; rates were stable during 1973-1988, before decreasing during 1989-1992 (Figure_1). During 1988-1992, the overall ratio of black-to-white death rates was 1.2 (Table_1). Rates increased directly with age (2). For women aged less than 70 years, the rate was higher for blacks than for whites; for women aged greater than or equal to 70 years, the rate was higher for whites than for blacks. During this period, race-specific rates varied. During 1989-1992, the rate for white women decreased 6% (from 27.5 to 26.0) and, for black women, increased 3% (from 30.4 to 31.2) (2). During 1988-1992, the state-specific age-adjusted death rate ranged from 18.2 in Hawaii to 35.3 in the District of Columbia (Table_1). Reported by: Div of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, CDC. Editorial NoteEditorial Note: The findings in this report indicate that incidence rates for breast cancer increased 34% during 1973-1992. The increase and later stabilization of incidence rates during the 1980s is most likely related to increased use of breast cancer screening methods (6) -- particularly mammography and clinical breast examination, which enable earlier diagnosis of the disease (3). The decrease in breast cancer death rates during 1989-1992 may reflect a combination of factors, including earlier diagnosis and improved treatment. For example, screening mammography and clinical breast examination are effective methods for reducing breast cancer mortality among women aged greater than or equal to 50 years (7). Survival from breast cancer increases when the disease is diagnosed at earlier stages, and from 1974-1976 to 1986-1991, the survival rate for invasive breast cancer increased substantially (2). Differences in the race-specific and state-specific incidence and death rates for breast cancer during 1973-1992 may reflect differences in factors such as socioeconomic status, access to and delivery of medical care, and the prevalence of specific risks for disease (1,5,8). For example, women in minority populations are less likely than white women to be screened for breast cancer (9). Although socioeconomic and risk-factor data were not analyzed in this report, the findings underscore the need for further characterization of the burden of cancer for U.S. women in racial/ethnic, geographic, and other subgroups. Early detection and appropriate treatment are essential to reducing the burden of breast cancer in the United States. CDC's National Breast and Cervical Cancer Early Detection Program provides early detection screening and referral services for cancers of the breast and cervix among older women who have low incomes or are uninsured, underinsured, or in a racial/ethnic minority. Additional efforts by this program and health-care professionals are needed to ensure that every U.S. woman at risk for breast cancer receives breast cancer screening, prompt follow-up, and assurance that tests are conducted in accordance with current federal quality standards. References
Figure_1 Return to top. Table_1 Note: To print large tables and graphs users may have to change their printer settings to landscape and use a small font size. TABLE 1. Number of deaths from breast cancer * and age-adjusted death rate +, by state and race & -- United States, 1988-1992 ================================================================================================================ No. deaths Rate -------------------------- ----------------------- Black-to-white State White Black Total White Black Total ratio -------------------------------------------------------------------------------------------- Alabama 2,440 871 3,318 23.5 @ 31.5 25.2 1.3 Alaska 158 ** 190 26.3 ** 23.6 ** Arizona 2,609 ** 2,707 24.6 ** 24.0 @ ** Arkansas 1,668 298 1,972 22.9 @ 30.3 23.8 @ 1.3 California 18,702 1,579 21,121 26.9 32.1 26.0 @ 1.2 Colorado 2,169 ** 2,260 24.9 ** 24.7 ** Connecticut 2,897 181 3,089 26.7 30.0 26.9 1.1 Delaware 593 ** 692 32.0 ** 32.5 ** District of Columbia 197 509 712 29.3 38.0 35.3 @ 1.3 Florida 11,859 1,158 13,044 25.2 @ 29.0 25.5 @ 1.2 Georgia 3,419 1,116 4,547 24.3 @ 27.4 24.9 @ 1.1 Hawaii 177 ** 546 25.4 ** 18.2 @ ** Idaho 712 ** 717 25.0 ** 24.7 ** Illinois 9,457 1,353 10,853 29.3 @ 32.8 29.5 @ 1.1 Indiana 4,513 365 4,888 26.7 33.9 27.2 1.3 Iowa 2,726 ** 2,756 26.5 ** 26.4 ** Kansas 2,078 ** 2,191 25.7 ** 25.8 ** Kentucky 2,823 231 3,062 25.4 33.0 25.8 1.3 Louisiana 2,324 1,046 3,386 25.0 33.2 27.2 1.3 Maine 1,110 ** 1,116 26.7 ** 26.7 ** Maryland 3,188 859 4,073 28.0 32.0 28.6 1.1 Massachusetts 6,110 201 6,335 30.1 31.2 30.0 @ 1.0 Michigan 6,959 1,071 8,070 27.5 33.7 28.1 1.2 Minnesota 3,686 ** 3,744 27.1 ** 26.9 ** Mississippi 1,290 631 1,922 22.7 27.8 24.2 @ 1.2 Missouri 4,271 449 4,734 26.1 32.0 26.6 1.2 Montana 626 ** 646 24.8 ** 24.8 ** Nebraska 1,431 ** 1,463 26.9 ** 26.8 ** Nevada 803 ** 861 26.7 ** 26.3 ** New Hampshire 1,021 ** 1,025 30.8 ** 30.7 ** New Jersey 7,474 894 8,423 31.5 @ 34.7 31.6 @ 1.1 New Mexico 963 ** 1,000 24.6 ** 23.6 ** New York 16,211 2,292 18,643 31.1 @ 29.6 30.5 @ 1.0 North Carolina 4,307 1,160 5,518 25.3 30.5 26.3 1.2 North Dakota 564 ** 575 27.3 ** 27.2 ** Ohio 9,404 987 10,409 28.3 32.2 28.6 1.1 Oklahoma 2,259 136 2,468 24.9 24.7 24.0 @ 1.0 Oregon 2,339 ** 2,389 25.7 ** 25.4 ** Pennsylvania 12,081 1,089 13,200 29.2 @ 34.8 29.6 @ 1.2 Rhode Island 1,103 ** 1,141 31.5 ** 31.6 ** South Carolina 1,995 745 2,744 25.5 29.0 26.3 1.1 South Dakota 606 ** 624 26.5 ** 26.3 ** Tennessee 3,358 688 4,056 24.1 @ 34.2 25.4 1.4 Texas 9,638 1,412 11,100 23.5 @ 30.3 24.0 @ 1.3 Utah 883 ** 897 23.3 ** 23.2 ** Vermont 494 ** 494 28.0 ** 27.9 ** Virginia 4,035 983 5,057 27.2 33.4 27.9 1.2 Washington 3,713 ** 3,851 27.1 ** 26.5 ** West Virginia 1,564 ** 1,631 24.7 ** 24.9 ** Wisconsin 4,312 130 4,455 27.3 33.1 27.3 1.2 Wyoming 320 ** 324 25.9 ** 25.6 ** Total 189,639 23,114 215,039 27.0 31.3 27.1 1.2 -------------------------------------------------------------------------------------------- * Decedents for which the underlying cause of death was breast cancer (International Classification of Diseases, Adapted, Ninth Revision, codes 174.0-174.9) were identified from public-use mortality data tapes (4). + Per 100,000 women. Adjusted to the age distribution of the 1970 U.S. population. & Numbers for racial/ethnic groups other than black and white were too small for meaningful analysis. However, all totals include numbers for other races. @ The difference between the state-specific rate and the corresponding U.S. rate is statistically significant (p<=0.0002, Bonferroni-adjusted). ** These data were excluded because the annual average number of persons in the denominator was <75,000. ================================================================================================================ Return to top. Disclaimer All MMWR HTML versions of articles are electronic conversions from ASCII text into HTML. This conversion may have resulted in character translation or format errors in the HTML version. Users should not rely on this HTML document, but are referred to the electronic PDF version and/or the original MMWR paper copy for the official text, figures, and tables. An original paper copy of this issue can be obtained from the Superintendent of Documents, U.S. Government Printing Office (GPO), Washington, DC 20402-9371; telephone: (202) 512-1800. Contact GPO for current prices. **Questions or messages regarding errors in formatting should be addressed to mmwrq@cdc.gov.Page converted: 09/19/98 |
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