Examining Breast Cancer Mortality Trends at the Community Level

Background:

Racial disparities in breast cancer mortality are well documented in Chicago. Despite significant advances in screening and treatment, black women in Chicago are 40% more likely to die from breast cancer compared to white women. Local- level data have the potential to shed light on the racial disparity as it is experienced on an individual and community level.  This information can lead to the development of tailored interventions for high-risk communities. The goal of this study is to conduct such a study for Chicago’s 77 community areas.

Methods:

Vital records data was utilized to calculate age-adjusted breast cancer mortality rates from 1999-2010 for Chicago’s 77 community areas. The rates were aggregated into two five year intervals 1999-2003 and 2006 – 2010. Comparative analysis was conducted for the 20 community areas with the highest mortality rates across both intervals. SAS 9.2 was used for data analysis. Trends in mortality rates were only compared when the community area had greater than 20 breast cancer deaths in at least one of the two time periods.

 

Results:

Throughout the study period, the 20 community areas with the highest breast cancer mortality rates were located on the South and Westside of the city. In both intervals, 90% or more of the high-risk communities were predominantly African American while the remaining communities were more racially-ethnically diverse. During the 2006-2010 interval, the mortality rates for the high-risk community areas ranged from 50 to 30 per 100,000 women compared to 27/100,000 women.

 

Conclusion:

Further studies of community-level trends are needed in context with trends in access to clinical resources and population demographics (i.e. race-ethnicity, employment and median income). Understanding the population and changes in local access to breast health services overtime may shed light on the observed trends in breast cancer mortality and point towards facilitators and barriers to improving outcomes for the most impacted communities.