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Breast cancer rates increase, but number of deaths falls

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Although overall cancer deaths are falling and new cases have leveled off, the cancer rate among women is increasing, a new report shows.

Deaths from breast cancer, the most common malignancy among women, fell 2.3% a year from 1990 to 2002. The decrease probably is a result of better treatments and early detection, says Elizabeth Ward, the American Cancer Society's director of surveillance research and an author of the Annual Report to the Nation on the Status of Cancer. The report is published today in the Journal of the National Cancer Institute.

The number of new cases of breast cancer, however, increased by 0.4% a year from 1987 to 2002, according to the report. More than 200,000 women were diagnosed with breast tumors in 2002.

The growth in breast cancer diagnoses is probably too great to be caused solely by the wider use of screening mammograms, says Brenda Edwards, associate director of surveillance research programs at the National Cancer Institute. Breast cancer rates rose steeply in the 1980s because mammograms helped detect many early tumors.

Edwards says slightly more women might be developing breast cancer because of lifestyle choices:

*Hormone replacement therapy. These drugs were widely used to relieve menopausal symptoms until a 2002 study found that they increased the risk of breast cancer by 26%.

*Delaying childbirth and having fewer children. Women who spend less time being pregnant are exposed to more estrogen.

*Obesity. Fat cells pump out chemicals that lead to higher estrogen levels, which could increase the risk of breast cancer after menopause.

Carolyn Kaelin, author of Living Through Breast Cancer, says women might be able to protect themselves through exercise and weight control.

In a 2004 report in the journal Cancer Epidemiology Biomarkers & Prevention, researchers found that women who gain 21 to 30 pounds after age 18 increase their risk of postmenopausal breast cancer by 40%. Women who gain more than 70 pounds double their risk compared with women who gain no more than 5 pounds.

Overall, women have a 1 in 7 chance of breast cancer, the cancer society says.

William Gradishar, director of breast oncology at the Robert H. Lurie Comprehensive Cancer Center at Northwestern University, notes that it is difficult to precisely pinpoint why breast cancer might be more common.

Gradishar, who was not involved in writing the report, says he was pleased to see the report show that most patients are being treated according to the best medical evidence, which doctors consider the "gold standard" for care.

The Centers for Disease Control and Prevention and the North American Association of Central Cancer Registries also contributed to the study.

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© Copyright 2004 USA TODAY, a division of Gannett Co. Inc.

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