The State of Our Health - Women's Health: Cancer Trends

The cancer that takes most women's lives (not counting lung cancer, the top category for both sexes) is cancer of the breast. Some types of cancer are difficult to detect and, consequently, survival rates after detection are quite low. Breast cancer can be detected early by mammograms. It has one of the highest survival rates. In the 1987-1994 period (most recent available data), if the survival rate of the population as a whole is taken as 100, those with breast cancer have an 84.6 survival rate. The rate for those with cancer of the pancreas is 4.2.

The chart shows the percentage of women aged 40 years or older who reported having a mammogram within the past two years. In the 12-year period shown (1987 to 1998), the number of women having this test has increased dramatically. Among white women, 29.6% reported undergoing a mammogram in 1987, 67.4% in 1998, a 128% increase. Blacks have done even better, going from 24% of women aged 40 or older to 66%, a 175% increase.

Deaths attributable to breast cancer have also declined in both groups. Among African American women of all ages, the death rate has dropped from 36.4 per 100,000 population (albeit after first rising to a 38.2 rate first) to 35.7%, a 2% decline. Among white women the rate has gone from 32.6 to 27.6, a 15.3% improvement. All death rates are age-adjusted, therefore comparable between the periods.

Declines in death rates clearly do not correlate strongly with the frequency of undergoing the mammography procedure. Other factors than detection are involved, clearly. As discussed earlier, socioeconomic factors play an important role in the higher incidence of death for black females.

We can trace this further by looking at cancer survival rates in the 1974 to 1994 period in five time periods. Whites have a significantly higher survival rate than blacks for the same condition — and the white survival rate has a more even progression, implying a more consistent application of diagnostic measures and therapeutic interventions.

The table below provides a numerical view of the chart, with survival rates added for four other cancers that take women's lives — lung cancer, cervical cancer, cancer of the uterus, and ovarian cancer. In all cases, black women have a lower survival rate than whites.

Breast Cancer Survival Rates

Survival Rates for Selected Cancer Sites, 1974-79 and 1989-94

Type of Cancer	Whites		Blacks
Period	1974-79	1989-94	1974-79	1989-94
Lung	16.7	16.5	15.4	13.9
Breast	75.2	86.7	63.1	70.6
Cervix uteri	69.4	71.5	63.0	59.0
Corpus uteri	87.5	86.5	59.2	54.4
Ovary	37.1	50.1	40.4	46.3
Bold indicates Blacks higher than Whites. Italics indicate a declining rate of survival.

Note here that lung cancer and ovarian cancer are difficult to detect. The symptoms of ovarian cancer are "vague and non-specific" according to MEDLINEplus. Pap smears can detect precancerous conditions in the cervix and in the uterus (in combination with pelvic exams). Among both groups, survival from lung cancer has declined. Among African Americans survival rates have declined in cervical and uterine cancer. Uterine cancer survival rates among whites have also dropped.

Detection is obviously only the first step — however, vital — to survival from cancers that take women's lives.

Source: U.S. Department of Health and Human Services. Health United States, 2001, p. 279. Online. Available: http://www.cdc.gov/nchs/products/pubs/pubd/hus/tables/2001/01hus082.pdf. Survival rates, same publication, are from National Institutes of Health, National Cancer Institute, Cancer Statistics Branch, Bethesda, Maryland 20892. Quotations from MEDLINEplus: Online. Available: http://www.nlm.nih.gov/medlineplus/ency/article/001566.htm.