Women in the United States have seen enormous advances in breast cancer treatment over the past two decades, but diagnoses are becoming more common, especially among younger women, according to a report released Tuesday by the American Society of Breast Cancer. Cancer.
The new report showed that breast cancer mortality has decreased by 44% since the late 1980s. Breast cancer rates, however, have increased by 1% each year since 2012. In younger women, they have increased at a faster rate: about 1.4% each year since 2021.
“That’s very alarming, because we know that screening starts at age 40,” said Dr. Sonya Reid, an oncologist at Vanderbilt University Medical Center, who was not involved in the report. “It is not just one racial or ethnic group that is affected, we are seeing it in all groups, so it is difficult to link it only to ancestral or genetic factors.”
Still, the report identified differences between different groups of women. Among Asian American and Pacific Islander women under age 50, breast cancer diagnoses have increased 50% since 2000. And rates among those under age 50 in this group are now higher than those of black women , Hispanic, of Indian origin and Alaska Natives of the same age group.
In 2000, Asian American and Pacific Islander women under age 50 had the second lowest rates of breast cancer.
What explains the increase in cases?
The reason why more women under 50 are getting breast cancer is unclear, but Reid said it is likely due to modifiable risk factors, such as environmental exposure to food, air or water. the increase in obesity rates and sedentary lifestyle.
These are the same risk factors that are believed to cause higher rates of colorectal cancer in increasingly younger people.
Dr. Wendy Wilcox, chief of women’s health at the New York City Health + Hospitals system, said it’s likely not a single factor driving the rise in breast cancer diagnoses among young women.
“There are all kinds of ideas we can throw around about why, but until it’s studied, we won’t know for sure,” Wilcox said.
The report also highlighted a stark racial disparity that has persisted for decades: Black women remain more likely to die from any type of breast cancer than white women.
“Seeing a 44% decrease in mortality is incredibly gratifying, but these advances have not been seen equally in all populations,” warned Dr. William Dahut, chief scientific officer of the American Cancer Society, during a conference Monday. of press.
It hasn’t always been this way: In 1970, black and white women had the same death rates from breast cancer. Today, black women are 5% less likely to get breast cancer than white women, but almost 40% more likely to die from the disease. American Cancer Society researchers noted that this disparity is seen even in the most treatable types of breast cancer.
“For a long time, the community had thought that the disparity was largely due to higher rates of triple-negative breast cancer, but this shows that black women are more likely to die from all subtypes of breast cancer,” Reid added. “These advances that we’ve seen are really due to improvements in therapeutic advances and early detection, and we know that if there are inequalities in access to these improvements, we will see an increase in these disparities.”
American Indian and Alaska Native women are 10% less likely to get breast cancer than white women, but 6% more likely to die from it, according to the report. Just over 50% of these women over 40 had had a mammogram in the past two years, compared to almost 70% of white women.
What the report says about Latinas
The report also revealed that Hispanic women are also less likely to be screened than white women.
Compared with white women, Asian American and Pacific Islander, American Indian, and Alaska Native women, black and Hispanic women are more likely to develop breast cancer at a younger age, according to the report.
However, Asian American and Pacific Islander and Hispanic women have similar mortality rates as white women.
To close disparities, the country will have to expand access to early detection testing and the best cancer treatments, according to Wilcox.
“The money allocated to health care is not distributed equitably among all the inhabitants of the country,” he said.
Even for those with insurance, coverage varies widely, and a person’s ability to take time off work to get a mammogram or medical care, and whether they live near a cancer center also play key roles in access, Wilcox said.
Each person’s family and personal history, as well as their genetics, will also determine when they should begin breast cancer screening.
“Going forward, we really need to make sure we have broad access to effective treatments for all of our patients,” Reid said. “We have seen that, despite the fact that there are more effective drugs, the racial disparity gap has not changed. Another drug is not going to do it.”
