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Poorer Women More Likely to Die From Breast Cancer

Less access to cancer screening and treatment is to blame, report says

TUESDAY, Oct. 4, 2011 (HealthDay News) -- Less-affluent women now face a greater risk of dying from breast cancer than wealthier patients, a new American Cancer Society report finds.

The trend represents a reversal of a previous trend, in which women with greater means had been at a greater risk for dying from the disease.

"In general, progress in reducing breast cancer death rates is being seen across races/ethnicities, socioeconomic status and across the U.S.," said Dr. Otis Brawley, chief medical officer for the American Cancer Society, in a society news release. "However, not all women have benefited equally."

"Poor women," he noted, "are now at greater risk for breast cancer death because of less access to screening and better treatments. This continued disparity is impeding real progress against breast cancer, and will require renewed efforts to ensure that all women have access to high-quality prevention, detection and treatment services."

The report, "Breast Cancer Statistics, 2011" is in the current issue of CA: A Cancer Journal for Clinicians.

More than 230,000 women will face a breast cancer diagnosis this year, and nearly 40,000 will die. The disease is the most common cancer among American women, after skin cancer, according to the report.

However, the overall U.S. breast cancer death rate has been on a steady decline for more than two decades. For women under 50, fatalities fell roughly 3 percent per year since 1990. For patients over 50, the drop was about 2 percent per year.

Death rates have gone down in 36 states and the District of Columbia between 1998 and 2007.

Yet the new report finds that death rates have not fallen at the same pace across all racial and socioeconomic lines, with the remaining 14 states experiencing little to no drop-off.

Until the early 1990s, women living in more-affluent areas had a higher death rate than those in poorer neighborhoods. But in the ensuing years, a relatively slow drop in death rates among poorer women has reversed the situation, so that today it is the less- affluent who are burdened with the highest death risk.

Dr. Rachel A. Freedman, a Boston-based medical oncologist with the Dana Farber Cancer Institute, said that less-affluent breast cancer patients face a "perfect storm" when it comes to mortality risk.

"Women from lower economic status have less access to resources, have suboptimal insurance coverage, may receive substandard care and often present with more advanced cancer at diagnosis," she noted. "So it's not surprising that they often face a substandard outcome."

"So it's a really complicated situation ... and that will mean that complicated interventions will be required to tackle this problem," she added. "But unfortunately, I don't see anything happening right now that's going to turn this around in the near term."

More information

For more on breast cancer mortality, visit the American Cancer Society.

SOURCE: Rachel A. Freedman, M.D., medical oncologist, Dana Farber Cancer Institute, Boston, Mass.; CA: A Cancer Journal for Clinicians, Sept. 22, 2011, news release
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