Although breast cancer death rates dropped by 43% from 1989 to 2020, Black women continue to be 40% more likely to die of the disease, despite a lower incidence, according to findings outlined in the American Cancer Society’s report Breast Cancer Statistics, 2022, and a companion study published by Giaquinto et al in CA: A Cancer Journal for Clinicians.
Breast cancer is the second leading cause of cancer death among women overall, but the leading cause of cancer death among Black and Hispanic women. In 2022, approximately 287,850 women in the United States are expected to be diagnosed with invasive breast cancer, and 43,250 are expected to die of the disease.
Black women have a lower breast cancer incidence than White women (127.8 vs 133.7 cases for every 100,000 individuals) but a 40% higher breast cancer mortality (27.6 vs 19.7 deaths for every 100,000 individuals). Among women younger than 50, mortality is higher by twofold (12.1 vs 6.5 deaths for every 100,000 individuals). This racial disparity has persisted unabated since 2011.
“We found that despite continued progress in reducing the risk of death from breast cancer, there is an alarming persistent gap for Black women. This is not new, and it is not explained by more aggressive cancer,” said senior report author Rebecca Siegel, MPH, an epidemiologist and Senior Scientific Director of Surveillance Research at the American Cancer Society. “We have been reporting this same disparity year after year for a decade. It is time for health systems to take a hard look at how they are caring differently for Black women.”
Key Findings From the Report
Other key findings from the report follow:
- Breast cancer incidence has risen by 0.5% each year since 2004, driven by diagnoses of localized and hormone receptor–positive disease.
- In total, the death rate dropped by 43% from 1989 to 2020, translating to more than 460,000 fewer breast cancer deaths during that time. This progress is likely the result of earlier detection through screening and increased awareness, as well as advances in treatment.
- However, the pace of decline in breast cancer death rates has slowed from 1.9% annually between 2002 to 2011 to 1.3% annually between 2011 to 2020, likely reflecting an increased incidence.
- Breast cancer death rates are declining in every racial and ethnic group except in American Indian and Alaska Native women, among whom rates are stable.
- Black women are the least likely of any racial or ethnic group to be diagnosed with breast cancer at a localized stage—57% compared with 68% in White women.
- Black women have the lowest 5-year relative survival rate of any racial or ethnic group for every breast cancer subtype and stage—except stage I—with the largest gaps for stage III (64% vs 77%) and stage IV (20% vs 31%) disease.
- American Indian and Alaska Native women are 17% less likely to be diagnosed with breast cancer than White women but 4% more likely to die of the disease.
“The slow decline in breast cancer mortality during the most recent period partly reflects stagnant screening uptake and suboptimal receipt of timely and high-quality treatment,” said contributing study author Ahmedin Jemal, DVM, PhD, Senior Vice President of the Surveillance & Health Equity Science Department at the American Cancer Society. “Coordinated and concerted efforts by policymakers, health-care systems, and providers are needed to provide optimal breast cancer care to all populations, including expansion of Medicaid in the nonexpansion Southern and Midwest states, where Black women are disproportionately represented. Also, increased investment is needed for improved early detection methods and treatments.”
“Lawmakers can and must do more to address the unequal burden of breast cancer among Black women, including increasing funding for the National Breast and Cervical Cancer Early Detection Program, a program jointly funded by federal and state governments that helps improve access to life-saving breast and cervical cancer screenings,” said Lisa A. Lacasse, President of the American Cancer Society Cancer Action Network. “Taking this step is critical to closing this persistent gap and moving us closer to ending cancer as we know it for everyone.”
Disclosure: For full disclosures of the study authors, visit acsjournals.onlinelibrary.wiley.com.
