Breast cancer mortality declined 58% since 1975, largely due to improved treatment

January 26, 2024

Source: Caswell-Jin, et al JAMA, January 16, 2024 LINK Calculations for this waterfall chart by me using data from the research. Deaths expressed per 100,000 women per year.

Breast cancer is a tragic disease, often diagnosed in young women, sometimes even during pregnancy. Women between 50-75 should have annual mammograms every other year, and the US Preventive Services Task Force is likely to soon recommend women at average risk start their every other year mammograms at age 40. Women at higher risk, based on family history, genetics, breast density or past biopsies are often recommended to have mammograms more often.

Breast cancer mortality has dropped 58% since 1975, from 64 deaths per 100,000 women per year to 27 deaths per 100,000 women per year. Researchers created multiple mathematical models as part of the Cancer Intervention and Surveillance Modeling Network to evaluate the underlying causes of this heartening decrease in breast cancer deaths and used published research data for these microsimulation models. The researchers adjusted the historical 1975 deaths to account for higher current rate of breast cancer diagnosis today. This report appeared in JAMA earlier this month.

As you can see, improved treatment of breast cancer represented about three quarters of the decreased mortality, while increased screening represented about a quarter of the decreased mortality.

Implications for employers:

-        We should continue to encourage mammography - as earlier detection clearly increases survival and decreases mortality significantly.

-        We should recognize that the medical care we purchase in 2024 is substantially better than the medical care that was available a few decades (or a few years) ago. This is one of the acceptable reasons for health care costs increasing.

-        Employer sponsored health insurance should provide coverage for effective treatment for breast cancer. Unfortunately, financial toxicity from the cost of cancer treatment is common among those with insurance.

-        Many employers and insurers already cover mammography without cost sharing for women starting at age 40, and rarely restrict coverage to every other year. This makes sense, since there are many women who have medical indications to have a screening mammogram every year instead of every other year.

Thanks for reading.  You can find previous posts in the Employer Coverage archive

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Monday: The perverse impact of employer sponsored health insurance on income inequality

2/4/24: Added Deaths expressed per 100,000 women per year to explain y axis of graphic