Fast Facts Social Factors in Breast Cancer Diagnosis of Breast Cancer in Public versus Private Hospitals Characteristics of Women with Low Breast and Cervical Cancer Screening Breast and Cervical Cancer Screening in Minorities References Fast Facts In the United States, breast cancer is the leading form of cancer among women and is second only to lung cancer as a cause of death.(1) It accounts for 31% of all newly diagnosed cancers in women and 15% of female cancer deaths.(1) One in every seven women in the United States will develop breast cancer by the age of 85.(2) Cervical cancer is the second leading cause of cancer deaths among women 20 to 29 years old.(3, 4) African-American females experience higher death rates from breast cancer than any other racial or ethnic group, even though whites experience higher incidence rates.(5) It has been observed that breast cancer among the elderly, African Americans, those of lower socioeconomic status (SES), and the un- and underinsured is more likely to remain undetected until the disease has advanced to regional or distant stages (when treatment is less effective and survival less likely) than when it occurs in the general population of women.(1)  Low-income women in general are at a higher risk of dying from this disease than more affluent women.(6) Social Factors Women living in areas with low mammography capacity and low socioeconomic status ranking were significantly more likely to have late-stage disease than women living in areas with higher mammography capacity and higher socioeconomic status.  Additionally, women living in areas that experienced a greater decrease in SES ranking in the decade prior to diagnosis were significantly more likely to have late-stage cancer than were women living in areas that experienced less deterioration.(1) Back to Top Diagnosis of Breast Cancer in Public versus Private Hospitals  A significantly higher proportion of women diagnosed in public hospitals were diagnosed at late stages, compared with women diagnosed in nonpublic hospitals (63.7% vs. 51.1%, respectively).(1) Regular screening for breast and cervical cancer are the key to lowering mortality rates from these diseases.  Characteristics associated with low rates of screening for breast and cervical cancer:(7) Being older or less educated U.S. federal poverty level Living in a rural area Lack of knowledge of preventive procedures Language barriers Lack of recommendation by a health care provider Concern about cost of mammogram Breast and Cervical Cancer Screening in Minorities  Hispanic women are less likely than are African American women or non-Hispanic white women to report prior breast or cervical cancer screening.(7)The women least likely to be screened are Hispanic women aged 65 years or older, although women in this age group are at greater risk for both cancers compared with younger women.(8) Obese women are less likely to be screened for cervical and breast cancer than non-obese women, even after adjustment for other known barriers to care.(3, 9) Back to Top  References 1. Mandelblatt J, Andrews H, Kao R, Wallace R, Kerner J. Impact of access and social context on breast cancer stage at diagnosis. J Health Care Poor Underserved 1995;6(3):342-51. 2. DevCan: Probability of Developing or Dying of Cancer Software, Version 5.1 Statistical Research and Applications Branch, NCI, 2003. http://srab.cancer.gov/devcan 3. Amonkar MM, Madhavan S. Compliance rates and predictors of cancer screening recommendations among Appalachian women. J Health Care Poor Underserved 2002;13(4):443-60. 4. Jemal A, Thomas A, Murray T, Thun M. Cancer statistics, 2002. CA Cancer J Clin 2002;52(1):23-47. 5. National Cancer Institute. Cancer Health Disparities Fact Sheet.  U.S. National Institutes of Health. Washington D.C. April 2002. http://www.nci.nih.gov/newscenter/healthdisparities#top 6. Hardy RE, Ahmed NU, Hargreaves MK, et al. Difficulty in reaching low-income women for screening mammography. J Health Care Poor Underserved 2000;11(1):45-57. 7. Skaer TL, Robison LM, Sclar DA, Harding GH. Cancer-screening determinants among Hispanic women using migrant health clinics. J Health Care Poor Underserved 1996;7(4):338-54. 8. Centers for Disease Control and Prevention. Hispanic Women in Border States Less Likely to Receive Screening for Breast and Cervical Cancers. CDC:Atlanta, March 19, 2003. 9. Fontaine KR, Faith MS, Allison DB, Cheskin LJ. Body weight and health care among women in the general population. Arch Fam Med 1998;7(4):381-4.     This research was supported by a National Library of Medicine (NLM) Publication Grant #5G08 LM07653-02 in support of the creation of a web site titled Factline: Tracking Health in Underserved Communities, www.factline.org. Saqi S. Maleque, MSPH, Researcher, Principal Investigator: Virginia Brennan, PhD.