distributed by age and ethnicity, as can be seen from the National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) data and mortality data from the National Center for Health Statistics (National Cancer Institute, 2002) (see Figures 4-1 and 4-2). For example, more than three-fourths of all breast cancers are diagnosed in women age 50 and older (American Cancer Society, 2002). White women have the highest incidence rate for every age group, while Native American, Aleutian Islander, and Alaskan Native women are least likely to develop breast cancer (see Figure 4-1).

Although the racial/ethnic patterns for mortality differ only slightly from incidence patterns, the highest mortality rates are found among African-Americans, followed by white and Hispanic women (see Figure 4-2). SEER data from the National Cancer Institute (http://www.seer.cancer.gov/) suggest that the higher mortality rate for African-American women is partially because their cancer tends to be diagnosed later, when cancer is less amenable to cure (National Cancer Institute, 2002).

Progress is being made in the fight against breast cancer. In the last period for which comparisons were made, 1987–1999, there was a 0.5 annual percentage change (APC) in breast cancer incidence; the incidence increased, partially because of continued increases in mammography use. The incidence increase was 0.4 APC for whites and 0.9 APC for African-Americans (Edwards et al., 2002). In part, this probably reflects the somewhat later adoption of mammography by African-American women. From 1990 to 1998, breast cancer-related death rates decreased for white women (2.5 percent per year) and Hispanic women (1.2 percent per year), and did not change for African-American, Native American/Alaskan Native, and Asian/Pacific Islander women (Garguilly et al., 2002). In the latest statistics, from 1995 to 1999, breast cancer mortality decreased 3.2 percent per year for all ages, 3.5 percent per year for whites, and 1.2 percent per year for African-Americans (1993 to 1999). This reflects important improvement in reducing deaths from breast cancer.



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