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Gap in Minnesota's black-white breast cancer death rates may have closed, report suggests

REUTERS/Eric Gaillard
The excess breast cancer death rate in black women varies from 20 percent in Nevada to 66 percent in Louisiana.

Minnesota is one of a handful of states where the breast cancer death rates for black and white women have become statistically equivalent, according to a new report from the American Cancer Society (ACA).

But whether that finding means this particular health disparity has been eliminated in Minnesota is not entirely clear. As the report also notes, the closing of the gap may simply reflect something researchers call a lack of statistical power — in this case caused by small numbers of breast cancer deaths among black women.

Still, there’s plenty of good news for Minnesota in the report, which was published Tuesday in CA: A Cancer Journal for Clinicians. The state’s breast cancer death rates for both white and black women are below the national average. In 2011-2015, the state’s overall breast cancer death rate for white women was 18.8 per 100,000, compared to the 21.2 national rate. And the breast cancer death rate for black women was 23.0 per 100,000, significantly lower than the 30.0 national rate.

(Again, rates of 18.8 and 21.2 may seem different, but in this case they may or may not be, statistically speaking.) 

National disparities continue

The implications from the national numbers — that black women are dying of breast cancer each year at a rate of 9 more per 100,000 than white women — underscores the stubborn pervasiveness of racial health inequities in the United States — inequities that are compounded by geographical disparities in health care.

Indeed, the excess breast cancer death rate in black women varies from 20 percent in Nevada to 66 percent in Louisiana.

“A large body of research suggests that the black-white breast cancer disparity results from a complex interaction of biologic and nonbiological factors, including differences in stage at diagnosis, tumor characteristics, obesity, other health issues, as well as tumor characteristics, particularly a higher rate of triple negative cancer,” said Carol Desantis, a cancer epidemiologist and director of breast and gynecological cancer surveillance at the ACA, in a released statement.

“But the substantial geographic variation in breast cancer death rates confirms the role of social and structural factors,” she added, “and the closing disparity in several states indicates that increasing access to health care to low-income populations can further progress the elimination of breast cancer disparities.” 

Additional findings

Here are some other findings from the report:

  • An estimated 252,710 new cases of invasive breast cancer and 63,410 cases of in situ breast cancer will be diagnosed in U.S. women in 2017.
  • An estimated 40,610 U.S. women are expected to die from the disease this year.
  • The median age at diagnosis for all U.S. women with breast cancer is 62 years. For white women, the median age at diagnosis is 63; for black women, it’s 59.
  • The median age of death from breast cancer is 68 years in the U.S. — 70 years for white women and 62 years for black women.
  • Women aged 50 years and older account for 81 percent of diagnosed breast cancers and 89 percent of breast cancer deaths.
  • A woman living in the U.S. has a 12.4 percent, or a 1 in 8 lifetime risk, of being diagnosed with breast cancer. (“Lifetime risk reflects an average woman’s risk over an entire lifetime, taking into account the possibility that she may die from another cause before she would have been diagnosed with breast cancer, and does not apply only to women who live to a very old age,” the report notes.)

And, finally, a heartening statistic: The overall breast cancer death rate in the U.S. dropped 39 percent between 1989 and 2015, averting 322,600 deaths during those 26 years. The decrease is thought to be the result of treatment advances (including better chemotherapy regimens), earlier detection through screening and increased awareness.

Still, the toll from the disease remains tragically high. Breast cancer is the second leading cause of cancer death among women in the U.S. Only lung cancer kills more women each year.  

FMI: The report, Breast Cancer Statistics, is published along with its consumer-oriented companion publication, Breast Cancer Facts & Figures, every two years by the ACA to describe the latest trends in breast cancer incidence, deaths and screening. You’ll find Breast Cancer Statistics at the website of CA: A Cancer Journal for Clinicians. Breast Cancer Facts & Figures can be found on the ACA’s website.

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