partially because of increases in screening (Wingo, Calle, and McTiernan, 2000).

A third reason mammography was chosen as an exemplar is because variations still exist in incidence and mortality rates by age and ethnicity that require further attention. For example, although incidence rates are higher for white women with higher incomes, African-American women and women who have low incomes and lower levels of education have the highest mortality rates from breast cancer—a finding that is attributed partially to delayed diagnosis. Figures 4-1 and 4-2 show breast cancer incidence and mortality rates by race and ethnicity (National Cancer Institute, 2002; Edwards et al., 2002). Recent data (Caplan, May,

FIGURE 4-1 Breast cancer incidence rates by race/ethnicity, all ages.

SOURCE: National Cancer Institute, 2002.



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