Breast cancer incidence and screening practices among university faculty women.

Abstract

T he incidence of breast cancer in the United States continues to rise, accounting for 32% of the cancer incidence among American women, according to 1994 cancer statistics.1 Breast cancer is the most commonly occurring cancer among women and is second only to lung cancer in causing cancer-related deaths, 18% versus 23%, respectively. In general, the earlier breast cancer is detected and treated, the greater the probability for a long disease-free survival. 2 Although increasing age, a family or self-history of breast or ovarian cancer, early age at menarche, late menopause, nulliparity, first full-term pregnancy after age 35, and Caucasian race are established risk factors for the disease, 3 there seems to be an increasing incidence among women with no known risk factors, at earlier ages, and during premenopausal and perimenopausal stages. The proportion of women age 65 years and older who are at increased risk due to their age alone will continue to rise, as the U.S. population of individuals 65 and older is expected to double from the 32 million in 1990 to 64 million in 2030. 4 Additional factors that have been found in some studies to be associated with increased risk, but are still controversial, include high fat diet, a dense tissue pattern on mammography, alcohol consumption, and estrogen and oral contraceptive use. 3 More recently, occupation has been proposed as a risk identifier by Rubin et al. 5 Rubin et al looked specifically at occupation as a risk identifier for breast cancer. 5 A database of occupationally coded death certificates was used to calculate age-adjusted, race-specific proportionate mortality ratios for breast cancer according to occupation. The findings of significant associations between occupation and frequency of breast cancer included high proportions of breast cancer death among white female professional, managerial, and clerical workers. Case-control analysis by occupation found the odds of breast cancer death to be between 2 and 2.23 times greater for teachers in higher education than for other occupational groups. The rising incidence figures may be due, in part, to women's increased awareness of early detection methods, such as breast self-examination, clinical breast examination, and screening mammography. 6 These factors in c o r n © 1995 by The Jacobs Institute of Women's Health 1049-3867/95/$9.5