- NEW YORK (Reuters Health)
- In the 1990s, a small but unexpected rise in the rate of large breast
cancers was observed among white women in the US, new research reveals.
Although large tumors are twice as common in African Americans, rates in
this group remained stable during the same period.
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- The findings are based on a study conducted by Dr. Michael
Thun and colleagues at the American Cancer Society in Atlanta. Data from
the National Cancer Institute's Surveillance, Epidemiology, and End Results
program and from the National Center for Health Statistics were analyzed
to assess recent breast cancer trends by race and ethnicity.
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- This year, the researchers predict more than 250,000
new cases of breast cancer and nearly 40,000 deaths among women in the
US. The findings are reported in CA: A Cancer Journal for Clinicians.
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- Since the early 1980s, increases in breast cancer rates
were observed among all women, the authors note. These rates have stabilized
for African American women since 1992, but continued to rise in other ethnic
groups except American Indians/Alaska Natives. In the latter group, a drop
in rates actually occurred between 1992 and 2000.
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- The rates of large tumors (greater than 5 centimeters
in diameter) among white women increased from 5.6 to 6.3 cases per 100,000
between 1992 and 2000, the authors note. Although this finding is partially
responsible for the overall increase in cancer rates, a rise in small and
localized tumors was mainly to blame for the overall trend in white women.
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- With the exception of small (no greater than 2 cm) tumors,
all other tumor sizes were more commonly seen in African American women
than in white women. In addition, African Americans were more likely to
be diagnosed with advanced disease than whites.
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- Other ethnic groups had lower breast cancer rates than
African Americans or whites. However, compared with whites, all other ethnic
groups were more likely to have their disease diagnosed at an advanced
stage and with larger tumor size.
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- Despite the rise in breast cancer rates, deaths from
the disease have actually dropped since the early 1990s. For whites, death
rates fell by 2.5 percent per year, whereas for African Americans the annual
drop was more modest--1 percent. By 2000, ethnic difference trends resulted
in a 32 percent higher death rate for African Americans compared with whites.
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- Currently, 63 percent of breast cancers are diagnosed
at an early stage and 29 percent are diagnosed at a more advanced stage,
the authors note. The corresponding five-year survival rates are 97 percent
and 79 percent.
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- "Although continued research is needed on the causes,
prevention, and treatment of breast cancer, much progress can be made by
applying current knowledge fully and equitably to all segments of the population,"
the researchers conclude.
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- SOURCE: CA: A Cancer Journal for Clinicians, November/December
2003.
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