Community trends in the early detection of breast cancer in Wisconsin, 1980-1998

Abstract

Background: Early detection of breast cancer is an important public health goal. Rates of early detection have increased over the past several decades, contributing to recent declines in mortality. Despite these overall trends, however, some populations have experienced less progress than others.

Methods: The rates of early detection, measured as the percentage of breast cancers diagnosed as breast carcinoma in situ, were calculated using data from Wisconsin's population-based tumor registry from 1980 to 1998. Trends in breast cancer (percent diagnosed in situ) were examined over time by socioeconomic characteristics of ZIP code of residence, using census data.

Results: The percentage of breast cancer cases that were breast carcinoma in situ was more than five times greater in the later period (1994-1998) (13.9%), compared with the early period (1980-1984) (2.6%). In the middle period (1987-1991), breast cancer was diagnosed as breast carcinoma in situ about one-third less frequently among women in areas with the lowest urbanization, median family income, and percent educated beyond high school, compared with communities with the highest levels of these variables. Recently disparities in early detection rates by community income and education indicators declined slightly, whereas disparities in percent of breast carcinoma in situ by urbanization did not.

Conclusions: Communities with lower levels of income, education, and urbanization lagged in the early detection of breast cancer during the 1980s and, despite some progress during the 1990s, continue to be underserved. Women in these communities should be targeted for interventions to improve the early detection of breast cancer.