Trends in racial and regional disparities in breast cancer mortality among the female population in the United States: A retrospective database analysis from 1999-2020.

Abstract

e13824 Background: Breast cancer mortality in the United States has been decreasing since the last decade of the 20th century due to improvements in treatment and early detection. However, racial and ethnic disparities in breast cancer death rates still persist. We aimed to explore racial and regional disparities among females who have died from breast cancer in the United States. Methods: Breast cancer patients were identified using CDC WONDER, a national mortality database that includes data from more than 99% of death certificates collected through the National Vital Statistics System. ICD-10 codes for breast cancer (C50.0 – C50.9) were used. Data were stratified by race, urbanization, census region and states with highest mortality rates represented per 100,000 population. Joinpoint regression analysis was used to trend the age-adjusted mortality rates (AAMR) during the study period from 1999 to 2020. Results: Between 1999 and 2020, a total of 1,113,711 female patients died from breast cancer with an AAMR of 32.3 per 100,000 in 1999 and decreasing to 24.2 per 100,000 in 2020. Among racial differences, the White female population had the highest proportional mortality of about 78.4% with AAMR of 27.3, however highest AAMR was observed in the Black population (35.8). In terms of regional differences, the South region had the highest number of death (36%) with an AAMR of 26.7, followed by the Midwest with the highest AAMR of 27.98. Large metropolitan areas recorded the highest number of deaths despite non-metropolitan areas with slightly higher AAMR. States in the top 90th percentile of AAMR are District of Columbia, Ohio, Mississippi, Oklahoma, Maryland and Louisiana. Conclusions: There have been significant reductions in mortality rates among breast cancer patients in the United States, however, with persistent racial disparities. This requires for continued vigilance in public health efforts and awareness for targeted screening and prevention strategies. Mortality proportions among sociodemographic patterns in the United States. Variables Age adjusted mortality rates Proportional mortality (%) Female (all) 26.96 per 100,000 100.0% White 27.30 per 100,000 78.40% Hispanic 16.94 per 100,000 5.33% Black 35.80 per 100,000 13.48% Asians 13.87 per 100,000 2.19% Natives 18.79 per 100,000 0.40% Large Metropolitan 27.03 per 100,000 52.60% Medium-Small metropolitan 26.71 per 100,000 30.38% Non-metropolitan 27.24 per 100,000 17.03% Northeast 27.34 per 100,000 20.15% Midwest 27.98 per 100,000 23.38% South 26.70 per 100,000 36.03% West 25.90 per 100,000 20.44%