Breast Cancer in New Jersey - 1979-1995
Breast Cancer in New Jersey Women

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INCIDENCE

Overall Incidence - 1979-1995

During the years 1979 through 1995, between 4,390 and 6,089 newly diagnosed cases of breast cancer among New Jersey women were reported each year. During each of the years 1979 to 1995, breast cancer accounted for about thirty percent of the total cancers diagnosed among New Jersey women. The annual age-adjusted incidence rate rose from 96.0 to 119.2 between 1979 and 1988, and then declined to 105.5 in 1995. (See Figures 1. and 2. and Table 8. in Appendix III.)

FIGURE 1.
Figure 1

FIGURE 2.
Figure 2

Age-Adjusted Incidence Rates by Race - 1979-1995

Ninety percent of the reported cases of cancer were among white women and eight percent were among black women. Throughout the years 1979 to 1995, white women had a higher age-adjusted incidence rate than black women. However, while the incidence rate of breast cancer among white women declined each year between 1991 and 1995, the incidence rate among black women declined in 1993 and 1994 and then increased in 1995. (See Figures 3. and 4. and Table 8. in Appendix III.)

FIGURE 3.
Figure 3

FIGURE 4.
Figure 4

Age-Specific Incidence Rates by Race - 1979-1995

During the time period 1979 through 1995, the age-specific incidence rates increased with each successive five-year age group, except for the 85 and over age group. In the younger age groups (20-24 through 35-39), black women had slightly higher incidence rates than white women. In the older age groups, white women had higher incidence rates than black women and the difference between the white and black rates generally increased for each successive age group up to age group 80-84. (See Figure 5. and Table 9. in Appendix III.)

FIGURE 5.
Figure 5

Selected Age-Specific Incidence Rates By Year - 1979-1995

The age-specific incidence rates of breast cancer for 1979 through 1995 followed a pattern similar to the overall age-adjusted incidence rates and to each other, though the annual increases and declines were more pronounced in the older age groups. For each year, the older the age group the greater the incidence rate of breast cancer, with the incidence rate in the oldest age group (70 and older) about 100 times the incidence rate in the youngest age group (20-29). (See Figure 6. and Table 10. in Appendix III.)

FIGURE 6.
Figure 6

Age-Adjusted Incidence Rates by County - 1986-1995

The age-adjusted incidence rates for the ten-year period of 1986 through 1995 varied among the twenty-one counties in New Jersey. (See Table 1.) (Note: The years 1979 through 1985 were not included in the Table 1. because an earlier report includes these years.)

TABLE 1.
FEMALE BREAST CANCER INCIDENCE AND INCIDENCE RATES
BY COUNTY AND RACE, NEW JERSEY 1986-19951

RACE ALL
RACES
WHITE BLACK OTHER
& UNK.
COUNTY No. Rate No. Rate No. Rate No.
Atlantic 1,654 108.6 1,412 111.2 221 95.4 21
Bergen 7,505 121.4 6,981 122.3 215 88.6 309
Burlington 2,607 115.5 2,297 115.7 247 104.0 63
Camden 3,443 112.7 2,949 113.4 392 98.4 102
Cape May 890 111.8 849 111.8 30 88.2 11
Cumberland 874 98.5 780 101.2 81 76.3 13
Essex 5,704 112.5 4,008 121.8 1,546 93.0 150
Gloucester 1,512 116.5 1,368 117.9 114 94.4 30
Hudson 3,353 94.0 2,886 94.8 312 86.1 155
Hunterdon 769 126.3 737 123.5 14 - 18
Mercer 2,538 120.3 2,138 121.8 354 113.5 46
Middlesex 4,622 114.5 4,275 116.9 214 93.7 133
Monmouth 4,447 121.8 4,119 124.7 229 83.0 99
Morris 3,165 121.8 3,011 122.5 56 78.9 98
Ocean 4,427 115.4 4,351 116.0 44 80.7 32
Passaic 3,091 104.5 2,805 108.3 232 71.3 54
Salem 448 100.0 398 102.5 49 86.8 1
Somerset 1,631 110.9 1,530 112.6 57 81.1 44
Sussex 811 119.4 798 119.1 2 - 11
Union 4,097 114.8 3,472 114.4 521 106.8 104
Warren 746 124.8 733 124.9 9 - 4
Unknown 82 - 29 - 1 - 52
STATE 58,416 114.1 51,926 116.0 4,940 93.4 1,550

1Incidence rates - per 100,000 women, age-adjusted to the 1970 U.S. population. Incidence rates were not calculated for women of other and unknown race, women from unknown counties or for numbers fewer than 20.

STAGE AT DIAGNOSIS

Stage at Diagnosis by Race - 1985-1995

Between 1985 and 1995, the annual percentage of women diagnosed with breast cancer in the earlier stages; i.e., in situ and localized stages, increased from 49 percent to 64 percent. (See Figure 7 and Table 11. in Appendix III.) In these same years the percent of breast cancer cases diagnosed in the in situ or localized stage increased greatly for both white (by 30%) and black women (by 41%), though black women continued to have a lower percentage of their breast cancer diagnosed at these early stages than did white women. (See Figures 8. and 9. and Tables 12. and 13. in Appendix III.) (Note: This analysis includes breast cancer cases diagnosed in the in situ and the invasive stages. The years 1979 through 1984 were not included in the analysis because the percentage of cases of cancer with an unknown stage at diagnosis was higher in these years.)

FIGURE 7.
Figure 7

Note: Does not include the percent of new cases with an unknown stage at diagnosis.

FIGURE 8.
Figure 8

Note: Does not include the percent of new cases with an unknown stage at diagnosis.

FIGURE 9.
Figure 9

Note: Does not include the percent of new cases with an unknown stage at diagnosis.

Stage at Diagnosis by County - 1986-1995

The percentage of breast cancer cases diagnosed in the early stages (in situ and localized) varied by county of residence. Salem, Warren, Burlington, and Morris counties each had over 60 percent of the breast cancer cases diagnosed in the early stages, while Gloucester, Hudson, Cape May, Atlantic, Mercer, and Essex counties had less than 55 percent of the breast cancer cases diagnosed in the early stages. (See Table 2. below and Table 14. in Appendix III.)

TABLE 2.
FEMALE BREAST CANCER STAGE AT DIAGNOSIS
BY COUNTY, NEW JERSEY - 1986-19951

COUNTYSTAGE AT DIAGNOSIS
TOTALIN SITULOCALIZEDREGIONALDISTANTUNKNOWN
No.PercentPercentPercentPercentPercent
Atlantic1,7746.847.227.28.710.1
Bergen8,2759.347.325.45.612.5
Burlington2,94211.450.024.25.98.5
Camden3,7839.047.624.66.811.9
Cape May9526.545.726.37.314.3
Cumberland9457.548.528.56.59.1
Essex6,33410.044.829.47.78.1
Gloucester1,6397.840.929.97.713.8
Hudson3,6046.943.630.68.010.8
Hunterdon8489.346.129.84.710.0
Mercer2,7688.345.726.57.112.4
Middlesex5,0548.547.824.97.011.8
Monmouth4,98610.845.426.65.312.0
Morris3,61912.548.527.55.46.0
Ocean4,8699.147.825.46.011.7
Passaic3,3377.349.528.96.57.9
Salem4827.157.323.75.07.1
Somerset1,84711.745.828.94.88.8
Sussex8949.348.827.66.08.3
Union4,59910.948.327.66.46.8
Warren84011.150.726.66.65.1
Unknown99-----
STATE64,4909.447.026.96.510.2

1Includes invasive and in situ cases. Percentages were not calculated for cases of unknown county.

MORTALITY

Overall Mortality - 1979-1995

Between 1979 and 1995 the number of deaths among women each year due to breast cancer varied from fewer than 1,500 to nearly 1,800. The age-adjusted mortality rate (number of deaths per 100,000 women) fluctuated between 27.1 in 1994 and 33.2 in 1985, though in the three most recent years, 1993 through 1995, the mortality rate was lower than in any of the fourteen previous years. (See Figures 10. and 11. and Table 15. in Appendix III.)

FIGURE 10.
Figure 10

FIGURE 11.
Figure 11

Age-Adjusted Mortality Rates by Race - 1979-1995

The annual age-adjusted mortality rates for white women were lower in the three most recent years than the previous fourteen years, but the mortality rates for black women in the three most recent years were not lower than the previous years. In each of the years 1979 through 1989, black women sometimes had a higher mortality rate and sometimes a lower mortality rate than white women. In the most recent years, 1990 through 1995, black women consistently had a higher mortality rate than white women. A higher mortality rate for black women is generally seen throughout the U.S., even though the breast cancer incidence rate for black women is lower than for white women. (See Figure 12. and Table 15. in Appendix III.)

FIGURE 12.
Figure 12

Age-Specific Mortality Rates by Race - 1979-1995

For 1979 through 1995, the overall and white age-specific mortality rates for five-year age groups increased with increasing age group. The same applied to the black age-specific mortality rates except the age group 65-69 was lower than the age group 60-64. For age groups 20 to 24 through 50-54 and 60-64, black women had higher mortality rates than white women; but in the age groups 55 to 59 and 65-69 and older white women had higher mortality rates than black women. (See Figure 13. and Table 16. in Appendix III.) This mortality pattern is similar to the incidence pattern.

FIGURE 13.
Figure 13

Age-Adjusted Mortality Rates by County - 1986-1995

The age-adjusted mortality rates for the years 1986 through 1995 varied among the twenty-one counties in New Jersey. (See Table 3.) (Note: The years 1979 through 1985 were not included in Table 3. because an earlier report includes these years.)

TABLE 3.
FEMALE BREAST CANCER MORTALITY AND MORTALITY RATES
BY COUNTY AND RACE, NEW JERSEY 1986-19951
COUNTYRACE
ALL RACESWHITEBLACKOTHER
& UNK.
No.RateNo.RateNo.RateNo.
Atlantic47629.139528.97830.53
Bergen1,99830.31,90731.16225.729
Burlington68029.659329.17934.88
Camden1,01031.886331.413734.610
Cape May22425.121424.810-0
Cumberland24326.421827.32321.12
Essex1,79033.51,20932.757434.67
Gloucester41532.137432.13934.62
Hudson1,08329.293729.012234.924
Hunterdon16827.516327.34-1
Mercer65529.955029.810432.91
Middlesex1,26930.51,20431.55727.78
Monmouth1,21331.91,11232.28932.012
Morris79029.776330.116-11
Ocean1,28030.81,25730.719-4
Passaic86928.077027.69329.66
Salem11625.510626.69-1
Somerset45129.742930.314-8
Sussex19626.819426.80-2
Union1,15130.097629.216234.013
Warren17126.516726.23-1
Unknown6-4-2-0
STATE16,25430.2 14,40530.1 1,69632.5153

1Mortality rates - per 100,000 women, age-adjusted to the 1970 U.S. population. Rates were not calculated for women of unknown county or other or unknown race or for numbers less than 20.

BREAST CANCER SCREENING

The Center for Health Statistics of the New Jersey Department of Health and Senior Services conducts a behavioral risk factor survey each year among a sample of New Jersey residents. The survey includes questions for women about receiving breast cancer screening services.

Women Age 40 and Over Who Ever Had a Mammogram

The estimated percentage of women in New Jersey age 40 and over who had ever had a mammogram increased from 69 percent in 1991 to 78 percent in 1995. However, a substantial proportion of women in this age group had not ever had a mammogram: 22 percent in 1995. The estimated percentage of women in New Jersey age 50 and over who had ever had a mammogram also increased, from 68 percent in 1991 to 80 percent in 1994, and then decreased to 76 percent in 1995. (See Table 4.; also see Appendix I Recommendations Regarding Screening for Breast Cancer.)

TABLE 4.
WOMEN AGE 40 AND OVER WHO EVER HAD A MAMMOGRAM
NEW JERSEY - 1991-19951

YEAREVER HAD A MAMMOGRAM
AGE > 40AGE > 50
PercentPercent
199169.167.6
199269.266.2
199378.777.0
199477.079.6
199578.476.0

1From the Behavioral Risk Factor Surveillance System, Center for Health Statistics, New Jersey Department of Health and Senior Services.

Women Age 40 and Over Who Had a Mammogram Within the Previous Two Years

The estimated percentage of women age 40 and over in New Jersey who had a mammogram within the previous two years increased from 61 percent in 1991 to 65 percent in 1995. During the same time period of 1991 to 1995, the estimated percentage of women age 50 and over who had a mammogram within the previous two years increased from 58 percent to 63 percent. (See Table 5.; also see Appendix I Recommendations Regarding Screening for Breast Cancer.)

TABLE 5.
WOMEN AGE 40 AND OVER WHO HAD A MAMMOGRAM
WITHIN THE PAST TWO YEARS, NEW JERSEY - 1991-19951

YEARHAD A MAMMOGRAM IN PAST TWO YEARS
AGE > 40AGE > 50
PercentPercent
199160.558.1
199258.956.5
199366.865.8
199464.264.9
199565.063.3

1From the Behavioral Risk Factor Surveillance System, Center for Health Statistics, New Jersey Department of Health and Senior Services.


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