Despite an overall decline in invasive breast cancer in the United States in recent years, African-American women, particularly younger ones, have not seen a significant decline in their rates, according to researchers at the University of Pittsburgh.

These findings, which were presented at the American Public Health Association (AHPA) Annual Meeting in Boston, strongly suggest the need for additional research to understand why these differences persist and to determine whether avoidable or preventable factors account for these puzzling patterns.

Although white women have the highest overall breast cancer incidence rates, African-American women under age 40 have a significantly higher incidence of breast cancer as well as a higher rate of death from the disease. Furthermore, African-Americans with breast cancer die at a younger age than women in other groups.

To further investigate racial disparities in breast cancer incidence, researchers from the University of Pittsburgh Cancer Institute's (UPCI) Center for Environmental Oncology, collaborating with researchers from Pitt's Graduate School of Public Health (GSPH), analyzed breast cancer incidence among African-American and white women in the United States from 1975 to 2002. This study found that the chances of getting breast cancer in newer generations are about 21 percent higher in whites and 41 percent higher in African-Americans than in previous generations of women.

The researchers attributed much of the increased incidence among white women to better detection, due to the widespread availability of mammographic screening beginning in 1994, and to the use of hormone replacement therapy. However, because mammographic screening is not recommended as often for younger African-American women, increased detection or changes in medical practice cannot explain the patterns of breast cancer seen in this ethnic group.

According to lead investigator Devra L. Davis, Ph.D., M.P.H., director of the UPCI Center for Environmental Oncology and professor of epidemiology, GSPH, these findings suggest that significant resources and research need to be directed toward understanding why younger African-American women are at significantly higher risk of developing breast cancer.

"The good news is that rates of invasive breast cancer are on the decline overall. However, African-American women, particularly younger women, have not shared in this trend. We need to find out very quickly why this is and take immediate steps to rectify the problem," she emphasized.

SOURCES:
American Public Health Association Annual Meeting, November 7, 2006, Boston, MA
University of Pittsburgh Medical Center (http://www.upmc.edu)