Rates of breast cancer — the second leading cause of cancer deaths in U.S. women — climbed 1% a year from 2012 to 2021, and even more sharply among women younger than 50 and among Asian American/Pacific Islander women of all ages, according to an American Cancer Society report published Tuesday.
The biennial report is among the most comprehensive and detailed studies of breast cancer occurrence over recent years. One in 50 U.S. women will develop invasive breast cancer by age 50, the authors said, based on National Cancer Institute calculations.
The sharpest increases in young adults by age during the decade were among women in their 20s, whose rate increased about 2.2% a year, though their absolute risk remains very low, at about 6.5 per 100,000 women.
Among Asian American/Pacific Islander women, who historically also have had a low prevalence of the disease, rates increased 2.7% a year among those younger than 50, and 2.5% a year among older women.
Cancer is generally considered a disease of aging, and that hasn’t changed: The vast majority of breast cancer cases and deaths still occur among older women. But the new study is one of several documenting a troubling uptick in malignancies among younger Americans.
These so-called early-onset cancers pose special challenges. Striking in early adulthood or midlife, they tend to be aggressive yet are often missed because they are not expected, and routine screenings are aimed at older adults.
This year, the U.S. Preventive Services Task Force lowered the age for initiating mammography to 40 from 50, reversing an earlier decision to raise the screening age. The American Cancer Society recommends starting annual mammography screening at 45 for women at average risk, with the option of starting at 40.
Despite the rise in incidence, deaths from breast cancer have plunged, dropping about 10% in the last decade and 44% in the past three decades because of improved screening and treatments.
But the benefits have not accrued equally to all women, according to the report, which was published in CA: A Cancer Journal for Clinicians.
Survival rates did not change at all for Native American and Alaska Native women. Breast cancer continues to be the leading cause of cancer deaths among Black women, who have a 38% higher death rate than white women.
“The bottom line is, we need to improve access to high-quality screening and high-quality treatment for all women of color, especially to Black and Native American women,” said Rebecca L. Siegel, an epidemiologist at the American Cancer Society and senior author of the report. “We need to expand that progress to all women.”
Some 310,720 new cases of invasive breast cancer will be diagnosed in U.S. women this year, including 13,180 cases in women younger than 40 and 37,650 in women in their 40s, the paper estimated. In addition, 56,500 cases of noninvasive ductal carcinoma in situ will be diagnosed in women of all ages.
An estimated 42,250 women will die of breast cancer, according to the study. Some 2,790 cases will be diagnosed in men, and 530 will die of it.
Breast cancer incidence rose 1% a year overall from 2012 to 2021. But women in their 20s, 30s and 40s experienced a 1.4% annual increase in incidence, while the increase among women 50 and older was more moderate, at 0.7% each year, the report found.
Getting a diagnosis often takes longer in younger women, leading to delays in treatment and more advanced disease.
This article originally appeared in The New York Times.
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