Breast density, which is associated with breast cancer risk, was found to be higher in black/African American women than white women when measured using novel quantitative methods, according to research presented at the American Association for Cancer Research’s annual meeting, held on April 18-22, 2015.
“Since breast density is associated with breast cancer risk, a better understanding of racial differences in breast density levels could help us identify women at the highest risk for breast cancer and target prevention strategies to those women,” says Anne Marie McCarthy, PhD, a research fellow at Massachusetts General Hospital in Boston.
Black women in the study had a significantly higher absolute area density of 40.1 cm2 compared with 33.1 cm2 in white women. In addition, black women had a significantly higher volumetric density of 187.2 cm3 compared with 181.6 cm3 in white women.
After adjusting for other factors associated with breast density, including age, body mass index, hormone therapy, and reproductive factors, black women were found to have significantly higher breast density than white women across all measures.
According to McCarthy, breast density refers to the amount of fibroglandular tissue in the breast when observed on a mammogram. Fibroglandular tissue appears as white on the mammogram, making it difficult to visually detect breast cancers. Research has shown that women who have the highest breast density have a four-to-six times greater risk for breast cancer compared with women with lower breast density.
Traditionally, radiologists examine mammograms and assign patients a breast density level; however, this assignment can be subjective, McCarthy says. Instead, in this study, McCarthy and colleagues used fully automated computer algorithms to produce both the conventional two-dimensional breast density measurement and a three-dimensional volumetric estimate of breast density. The study included 1,589 black/African American women and 1,256 white women who underwent screening mammography at the University of Pennsylvania from 2010 to 2011.
“Our findings are using a new, quantitative and, perhaps, more reliable way to measure breast density,” McCarthy says. “Our next step will be to see how quantitative density measures and other imaging biomarkers are associated with cancer risk, cancer subtype, and stage of diagnosis by race.”
This study was funded by the National Institutes of Health. The computer software used for breast density estimation has been made publicly available and free for research purposes by the University of Pennsylvania.
Many adults in the United States are not getting the recommended screening tests for colorectal, breast, and cervical cancers, according to data published in the Centers for Disease Control and Prevention’s (CDC) Morbidity and Mortality Weekly Report. For 2013, screening for these types of cancers either fell behind previous rates or showed no improvement.
Among adults in the age groups recommended for screening, about 1 in 5 women reported not being up-to-date with cervical cancer screening, about 1 in 4 women reported not being up-to-date with breast cancer screening, and about 2 in 5 adults reported not being up-to-date with colorectal cancer screening.
The report found that colorectal cancer testing was essentially unchanged in 2013 compared with 2010. Pap test use among women aged 21 to 65 years was lower than in 2000, and the number of mammography screenings was stagnant, showing very little change from previous years.
“It is concerning to see a stall in colorectal cancer screening rates,” says Lisa C. Richardson, MD, MPH, director of CDC’s Division of Cancer Prevention and Control. “We must find new ways to make people and providers aware that getting tested for colorectal cancer could prevent cancer and save their lives.”
Researchers reviewed data from the National Health Interview Survey 2013, which is used to monitor progress toward Healthy People 2020 goals for cancer screening based on the most recent U.S. Preventive Services Task Force guidelines.
The screening data for 2013 show that 58.2% of adults aged 50 to 75 years reported being screened for colorectal cancer; 72.6% of women aged 50 to 74 had a mammogram; and 80.7% of women aged 21 to 65 had a Pap test. All of these percentages are below the Healthy People 2020 targets.
The report found that adults without insurance or a usual source of health care generally had the lowest screening test use. For example, less than one quarter of adults in these groups reported recent colorectal cancer screening, compared with more than 60% of adults with private insurance or a usual source of health care. More efforts are needed to achieve cancer screening goals and reduce screening disparities.
The authors did report some good news: the proportion of women in the highest education and income groups who were screened for breast cancer exceeded the Healthy People 2020 target, and the proportion of people aged 65 to 75 who were screened for colorectal cancer was also near the target.
Through the Affordable Care Act, more Americans will qualify to get health care coverage that fits their needs and budget, including important preventive services such as screening for some cancers that may be covered with no additional costs. Visit Healthcare.gov to learn more.
About one in three adults aged 50 to 75 years have not been tested for colorectal cancer as recommended by the United States Preventive Services Task Force (USPSTF), according to a new Vital Signs report from the Centers for Disease Control and Prevention (CDC). Despite research that shows colorectal cancer screening tests save lives, screening rates remain too low.
“There are more than 20 million adults in this country who haven’t had any recommended screening for colorectal cancer and who may therefore get cancer and die from a preventable tragedy,” said CDC Director Tom Frieden, MD, MPH. “Screening for colorectal cancer is effective and can save your life.”
Colorectal cancer is the second leading cancer killer among men and women in the United States, after lung cancer. Screening tests can prevent cancer or detect it at an early stage, when treatment can be highly effective. Adults aged 50 years and older should get tested with one or a combination of these screening tests:
• Fecal occult blood test (FOBT) or fecal immunochemical test (FIT) done at home every year;
• Flexible sigmoidoscopy, done every five years, with FOBT/FIT done every three years;
• Colonoscopy done every 10 years.
A colonoscopy can detect cancer early, and it can find precancerous polyps so they can be removed before they turn into cancer. An FOBT/FIT is a simple at-home test that can detect cancer early by identifying blood in the stool, a possible sign of cancer. People are not always offered a choice of colorectal cancer tests, but studies have shown that people who are able to choose the test they prefer are more likely to get the test done.
CDC researchers reviewed colorectal cancer screening data from CDC’s 2012 Behavioral Risk Factor Surveillance System to estimate the percentage of people aged 50 to 75 years who reported getting screened as recommended by type of test.
Major Findings
• Among adults who were screened as recommended, colonoscopy was by far the most common screening test (62%). Use of the other USPSTF-recommended tests was much lower: FOBT (10%), and flexible sigmoidoscopy in combination with FOBT/FIT (less than 1%).
• The highest percentage of adults who were up-to-date with colorectal cancer screening was in Massachusetts (76%).
• The percentage of people screened for colorectal cancer using the FOBT within one year was more than twice as high in California (20%) when compared with most states.
• Blacks and whites had similar screening rates, but a higher percentage of blacks across all income and education levels used FOBT.
The authors noted that increasing use of all tests may increase screening rates. Furthermore, research shows that more people may get tested if health care providers used an organized approach to identify people who need to be screened: contact them at their home or community setting; advise them of each test; and carefully monitor to make sure they complete their test.
CDC provides funding to 25 states and four tribal organizations across the United States to help increase colorectal cancer screening rates among men and women aged 50 years and older through organized screening methods. Through the Affordable Care Act, more Americans will have access to health coverage and preventive services like colorectal cancer screening tests. The tests will be available at no additional cost. Visit Healthcare.gov or call 1-800-318-2596 (TTY/TDD 1-855-889-4325) to learn more.
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