Friday, December 29, 2006

A sharp decrease in breast cancer incidence in the United States in 2003.

Hey I was just posting this abstract on my forum and thought I'd share here, its not low carb but certainly interesting, especially for the ladies!

From Abstracts2view

A sharp decrease in breast cancer incidence in the United States in 2003.

Ravdin PM, Cronin KA, Howlander N, Chlebowski RT, Berry DA.. MD Anderson; National Cancer Institute; Harbor UCLA Medical Center

Introduction: The epidemiology of breast cancer may provide useful insights into risk factors for this disease, and the impact of various interventions on this disease's incidence and mortality. Modeling efforts, such as those of the Cancer Intervention and Surveillance Modeling Network (CISNET) have provided insight into the relative impact of screening and adjuvant therapy on these endpoints (NEJM 353:1784-1792,2005). Although randomized clinical trials such as those investigating the impact of hormone therapy, diet, and exercise provide the strongest evidence as to the influence of these factors, epidemiologically based models, particularly when there is a large change in these factors, may allow additional insights.

Methods: SEER public use data from 1990 to the end of 2003 was used in these analyses.

Results: Breast cancer incidence in the United States gradually increased at 1.7% per year from 1990 to 1998. Between 1998 and 2003 incidence began to decrease at 1% per year. In 2003 there was a 7% decrease in incidence within a single year. This marked decrease was seen both for in situ cancers (5.5%) and malignant cancers (7.3%). In order to gain additional insight as the possible reasons for the decline in incidence of breast cancer we conducted further subset analyses. The steep decline seemed to begin in early 2003 with relative rates (compared to a 2000/2001) showing a 1% decline in the first and second halves of 2002, 6% in the first half of 2003, and 9% in the second half of the year. The decline in incidence in 2003 relative to 2000/2001 was most evident in patients older than 50 (a 1%, 11%, 11%, and 7% decline in incidence for women in their 40s, 50s, 60s, and 70s respectively). The decline in incidence in ER positive invasive tumors was greater than ER negative tumors (8% versus 4%). When the analysis was restricted to patients 50-69 years of age this difference in decline in the incidence by ER was more striking (12% versus 4%).

Conclusions: In 2003 a steep decrease in the incidence of breast cancer occurred in the United States. This decrease was most evident in patients older than 50, and largely occurred because of a decrease in the incidence of estrogen receptor positive breast cancer. Trends in use of hormone therapy (which decreased markedly in late 2002 following the publication of Womens Health Initiative results) and other medications potentially linked to breast cancer risk will be discussed in this context.

Thursday, December 14, 2006 10:45 AM


Cindy said...

There's also the theorey that there are less cases found because there's been a dramatic decrease in access to mammograms.

Only time will tell I guess.

Sherrie said...

Thats interesting Cindy, why was there a dramatic decrease in access to mammograms?

You would think if anything they would be encouraging even more access to mammograms for the 50s and 60s group which have the largest decline and less risk?

Cindy said...

Sherrie...apparently docs are still pushing them, but the ins companies have cut back on reimbursement, so there are places that are closing. Closings mean more people going to the centers left, making it harder to get an appt.

Here in NC I've never had a problem....I can make an appt for next week or next year without a problem. Apparently in some areas women have to wait several months, and many don't even bother.

There are also more women (and men and children) without insurance, and mammo's aren't free.

Anonymous said...

Mammograms are no good. The theory is that if there is a tumour in the breast, squashing the breast as is done in a mammogram will spread the tumour.

Sherrie said...

Cindy thats no good!

Hey Anon

We were discussing that in a thread called Mammogram Dangers
From what I recall I think it was saying for the older age group it was more beneficial but not worth the risk for the younger age groups (eg before menopause).

Cindy said...

Medicare coverage isn't a problem, nor I believe is private coverage. The problem is more that in some areas centers are closing, making it much more difficult to get the tests.

There is funding available for women with no coverage, but I'm sure it's a major hassle getting help.

In general, in the US, there are more people without insurance, or with poorer coverage each year. The gap between Medicaid and Medicare with uninsured is widening. Fewer people qualify for Medicaid, and more people are finding coverage impossible or inadequate due to increased cost and decreased coverage.

Cindy said...'ve been tagged: