A look at the “Reasons why US breast cancer mortality declined between 1975 and 2019” – The decline in breast cancer mortality in the US between 1975 and 2019 is a significant public health achievement. The age-adjusted rate decreased from 48 deaths per 100,000 women in 1975 to 27 deaths per 100,000 women in 2019 [1]. This represents a 43% drop in the death rate from 1989–2020, leading to 460,000 fewer breast cancer deaths during that time [2]. However, it is important to note that between 1989 and 2010, breast cancer mortality rates decreased at varying rates across different age groups [3]. Despite the pandemic, the cancer death rate, including breast cancer, continued to decline from 2019 to 2020 [4]. What led to this decline in breast cancer mortality in the US between 1975 and 2019?
Reasons why US breast cancer mortality declined between 1975 and 2019
The significant decline in US breast cancer mortality between 1975 and 2019, a near 60% reduction, can be attributed to several key factors:
1. Early Detection Through Screening
Widespread adoption of mammography: Early detection through mammography screening played a crucial role in identifying cancer at its earliest stages, when treatment is more effective. This led to less invasive procedures and improved survival rates. Targeted screening: Increased awareness and efforts to encourage high-risk groups to participate in screening further contributed to the decline.
2. Advancements in Treatment
Improved surgical techniques: Minimally invasive surgeries and advancements in reconstruction techniques allowed for quicker recovery times and better cosmetic outcomes. Enhanced radiation therapy: More precise targeting and reduced side effects made radiation therapy more tolerable and effective. Novel drug development: Targeted therapies and immunotherapy have revolutionized treatment options, offering better control and extending life expectancy, particularly for advanced stages.
3. Increased Survival After Advanced Stages
Targeted therapies: New drugs specifically targeting cancer mutations have shown remarkable effectiveness in controlling the spread of advanced cancer and improving survival rates. Improved supportive care: Advancements in pain management, palliative care, and supportive therapies have enhanced quality of life for patients with advanced disease.
4. Additional Contributing Factors
Increased awareness and education: Public awareness campaigns and educational initiatives encouraged women to be proactive about their health and seek early detection. Improved access to healthcare: Expanded insurance coverage and healthcare access programs ensured that more women had the opportunity to receive preventive care and treatment. Research and development: Continued research into breast cancer biology, diagnosis, and treatment continues to fuel progress and pave the way for even better outcomes.
What Scientists Found recently
In a recent study, researchers used computer models to analyze breast cancer patients and mortality rates from 1975 to 2019. They separated the impact of three factors: screening, treatment of early-stage cancer, and treatment of advanced (metastatic) cancer. The analysis used data from over 82,000 patients and was compared to actual mortality trends.
The Results
58% decrease in mortality: This impressive overall improvement breaks down to:
- 29%: attributed to earlier detection through screening (mammography)
- 47%: attributed to better treatment for early-stage cancer
- 25%: attributed to improved survival after advanced stages
Survival after advanced stages increased: Notably, patients diagnosed with advanced cancer saw a rise in survival time, particularly those with specific types of breast cancer (ER+/ERBB2+).
Screening most effective for specific cancer types: Interestingly, screening had a greater impact on reducing mortality for certain types of breast cancer (ER−/ERBB2−).
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