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Upstate New York Breast Cancer Facts and Mammography Screening Rates Highlight a New Excellus BlueCross BlueShield Report

Submitted by Excellus BlueCross BlueShield

Breast cancer, the second leading cause of cancer death (behind lung cancer) among American women, claimed the lives of more than 14,000 New York state women from 2003 through 2007, and a total of 70,000 new cases were diagnosed statewide from 2002 through 2006, according to a report released today by Excellus BlueCross BlueShield.

“The Facts About Breast Cancer and Mammography Screening Among Women in Upstate New York” reports that according to the most recent five years of data available, there were a total of 3,700 breast cancer deaths (from 2003 through 2007) and about 19,000 new breast cancer diagnoses (from 2002 through 2006) among upstate New York women.

The 3,700 breast cancer deaths in upstate New York translate to an annual average of 29.7 per 100,000 women. Average annual breast cancer death rates from 2003 through 2007 ranged from lows of 26 to 27 deaths per 100,000 women in the Finger Lakes, Central New York and Utica/Rome/North Country regions to highs of 31 to 35 deaths per 100,000 women in the Southern Tier and Western New York.

The 19,000 new breast cancer diagnoses among upstate New York women equal an annual average breast cancer incidence rate of 152.2 per 100,000 women, which is more than 9 percent higher than the statewide rate (139.2 per 100,000). The rate in Central New York was slightly lower than the statewide rate; Western New York (162.5 per 100,000) and the Finger Lakes region (156.1 per 100,000) had the highest rates; and both the Southern Tier and the Utica/Rome/North Country region rates were about 149 per 100,000.

“Studies show that mammograms and recent treatment advances have substantially reduced breast cancer death rates,” said Arthur Vercillo, M.D., regional president, Excellus BlueCross BlueShield. According to the Centers for Disease Control and Prevention, mammography every one to two years among women ages 40 and older can cut 10-year breast cancer mortality by 20 percent to 25 percent. A film mammogram (X-ray of the breasts) is the primary method for detecting breast cancer.

While the vast majority of women ages 40 and older report that they’ve had a mammogram at some point in their lives, the percentage who say they’ve had a mammogram within the past two years has fluctuated since 2002. A 2008 statewide survey cited in the Excellus BlueCross BlueShield report shows that the percentage of upstate New York women ages 50 and older who reported having had a mammogram within the previous two years (84.6 percent) was slightly higher than the comparable statewide rate (82.5 percent). Regionally, the two-year mammography rate among women ages 50 and older ranged from 80.1 percent in the Southern Tier to 88.8 percent in Central New York.

Analysis of socioeconomic factors related to mammography use over the previous two years among upstate New York women in the 50-plus age group surveyed in 2008 shows that the higher a woman’s income, the more likely she was to report having had a mammogram within the past two years. Employed and retired women had the highest reported two-year mammography rates, while those unable to work had the lowest. Those with health coverage reported a substantially higher two-year mammography rate (84.6 percent), compared to the uninsured (76.9 percent).

Vercillo acknowledged that experts disagree on the most beneficial age to begin regular mammography screening and how often women should be screened. For women of average risk, the American Cancer Society recommends beginning mammography at age 40 and including clinical breast exams in routine screenings.

The U.S. Preventive Health Services Task Force 2009 guidelines recommend biennial screening from age 50 to age 74 and suggest screening before age 50 only on an individualized basis. It notes that the benefits versus risks of screening prior to age 50 are relatively small weighed against the potential harms associated with mammography, such as false positive results and the treatment of cancers that never would have shortened a woman’s life.

“There’s no doubt that mammography remains the gold standard for the early detection of breast cancer,” said Vercillo. “At the very least, all women between the ages of 50 and 74 should have a mammogram every two years, and women of other ages should discuss their breast cancer risk and the possible benefits of mammography screening with their doctors.”

Breast cancer risk factors are:
• Age. One in eight cancers appears in women under age 45; two out of three are found in women ages 55 and older.
• Genetics. An inherited mutation of the BRCA1 or BRCA2 genes is the most common cause of hereditary breast cancer.
• Family or personal history of breast cancer. Having a first-degree relative (mother, sister or daughter) with breast cancer doubles one’s risk; having two first-degree relatives with the disease raises the risk about fivefold. Those who already had breast cancer have a threefold to fourfold risk of developing a new cancer.
• Race. White women are slightly more likely to develop breast cancer than are black women, although black women who develop the disease are more likely to die from it than their white counterparts.
• Certain breast tissue conditions, including dense breast tissue, certain benign breast conditions and certain benign cysts.
• Exposure to chest irradiation as a child or young adult.
• Early-onset menstruation (before age 12) and/or late menopause (after age 55).
• Not having children or having them later in life.
• Recently using oral contraceptives.
• Taking post-menopausal hormone therapy
• Not breastfeeding.
• Being overweight or obese.
• Not being physically active.
• Using alcohol.

To view the complete fact sheet, go to excellusbcbs.com.