Welcome from the Director
The 1997 California Breast Cancer Research Symposium presents an unique opportunity for all individuals interested in breast cancer research to hear the latest in progress from the innovative projects funded by the Breast Cancer Research Program, and to interact with California scientists, breast cancer activists, Council and staff members about topics in breast cancer research. Augmented with exhibits by breast cancer/health organizations and art displays by and about those affected by breast cancer, the event promises to impact all who attend.
All Californians are touched by breast cancer, which has for decades taken a tragic toll among the people of California. The cost of this disease is a cost measured in human suffering, in lives lost, in wasted potential, and in medical care dollars. In 1996 alone, it is estimated that 184,000 women in the US (20,000 in California alone) were diagnosed with breast cancer and 44,300 (4,500 in California) succumbed to the disease. Over half of these women are in the prime of their lives (less than age 65), depriving children of their parents, the private and public sectors of experienced employees at their height of productivity, and decades of life for those who are lost. Very recent data suggests that deaths from breast cancer may finally be decreasing, but the decrease has been small, and does not reflect other facts. A similar decrease in death rates was seen in the late 1970's, but was not sustained. Second, the current decrease could be due to lead time bias with an increase in the proportion of in situ and early stage cancers being diagnosed. Finally, death rates for African-American women have actually increased over this same time period.
The funds which the Program directs to research on the causes, prevention, detection and cure of breast cancer are not just monies spent, but are an investment in the future of Californians. By encouraging and identifying innovative research on breast cancer, and attracting and training some of the most talented and gifted scientists into this area of research, California is making a research investment that will translate into lives saved for Californians in years to come. The specific areas of research supported, as determined by the Breast Cancer Research Council with input from stakeholders across the state, include the basic and clinical sciences, social and behavioral research, technology development and public health research. New program areas in translational and collaborative research, as well as community partnerships, have been developed. CBCRP funds support research projects and training of both young and experienced scientists and health professionals in breast cancer-related research, as well as partnerships of community members/agencies and scientists. These funds provide critical leverage in developing new scientific infrastructure and networks crucial for a broad-based and comprehensive approach to the problem of breast cancer. CBCRP's challenge is to allocate funds rapidly and flexibly to assure that new and promising ideas are brought quickly to impact the disease.
The first three years of the program have marked a period of important achievements for the CBCRP. The projects funded by the Program in 1995 and 1996 are now well underway, with preliminary progress to be reported for the first time at this Symposium. This event will encourage exchange of ideas between these scientists and those newly funded in 1997. Breast cancer advocates, legislators and their staff, and the general public will learn from these research efforts and share their own ideas and experiences to make an enriching experience for all involved.
In 1993, the California legislature recognized the need to respond to the continuing crisis of breast cancer. With the passage of the Breast Cancer Act of 1993, an ongoing (although declining) source of funds from tobacco taxes was secured to support 3 arms of a state effort to decrease the human and economic cost of breast cancer in California. Forty-five per cent of the funds were allocated to the Breast Cancer Research Program, which was established at the University of California to spearhead research efforts on the causes, prevention, detection and cure of breast cancer. (The remaining funds are allocated to the Breast Cancer Early Detection Program and the State Cancer Registry). The Breast Cancer Research Council, which is an advisory committee to the UC Vice President for Health Affairs, determines the goals and priorities of the research program, establishes program policies, oversees peer review of submitted applications and makes funding recommendations.
Breast cancer is the most commonly diagnosed cancer among women of any race/ethnic group in California, and is second only to lung cancer in cancer-related deaths. In 1996, alone, it is estimated that 20,000 women in California were diagnosed with breast cancer and nearly 4,500 died of the disease.
The incidence of breast cancer in the state climbed steadily during the time such data was being collected (i.e., since 1973 for the San Francisco Bay area) until 1987. Since 1987, rates have decreased slightly and now appear to have leveled off. Age-adjusted rates dropped from 111.8 per 100,000 in 1988 to 106 per 100,000 in 1993. These rates, however, varied markedly by race/ethnicity in the same time period, with non-Hispanic white women having the highest rate, followed by African American women, Hispanic women, and Asian women, respectively. Among women younger than 50, however, African American women have a higher rate than white women.
Rates of death due to breast cancer have remained relatively constant in the United States during the last three decades, but have decreased approximately 14% in California since 1985 (about 2% per year). Unfortunately, this decrease has only been consistent and statistically significant for non-Hispanic white women. In addition, although African American women have a lower incidence of breast cancer than white women, the death rate is higher for African American women.
Mammography usage has increased markedly in the past decade, probably accounting in part for both the increased incidence of breast cancer and the decreased mortality. In 1987, only 46.7% of California women aged 40 and over reported ever having had a mammogram. By 1994, this figure had increased to 82.8%. Asian and Hispanic women, less educated women and those reporting a lower income, however, are less likely to have received screening and are therefore at greater risk for being diagnosed with breast cancer at a later stage.
These data are most remarkable for the lack of significant change over time, despite advances in knowledge and in detection and treatment of breast cancer. It is hoped that the significant investment that California has started to make will impact these statistics in years to come.
