title: Temporal trends in breast cancer mortality by state and race.
abstract: OBJECTIVE
  To examine how temporal trends in age-standardized female breast cancer death rates vary by state and race.
  
  
  METHODS
  We analyzed mortality data from the National Center for Health Statistics (NCHS) for the years 1975 through 2004 by state and race using joinpoint analyses.
  
  
  RESULTS
  By 2004, breast cancer death rates in white women were decreasing in all 50 states and the District of Columbia (DC), with the onset of decline varying by state. In contrast, among African American women, breast cancer death rates increased in two states (Arkansas and Mississippi) of the 37 states analyzed, were level in 24 states, and decreased in 11 states. In general, states that showed little progress in reducing breast cancer mortality rates over time had higher death rates in 2003-2004.
  
  
  CONCLUSIONS
  Trends in breast cancer death rates vary widely by state and are considerably less favorable in African American than in white women. State cancer control efforts should ensure that all women have access to high-quality early detection and treatment services.
authors.affiliation: Epidemiology and Surveillance Research, American Cancer Society, 250 Williams Street, NW, Atlanta, GA, 30303, USA. carol.desantis@cancer.org
authors.forename: Carol
authors.initials: C
authors.lastname: DeSantis
authors.forename: Ahmedin
authors.initials: A
authors.lastname: Jemal
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Ward
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Thun
mesh_terms: D001943:Breast Neoplasms / Q000208:ethnology* / Q000401:mortality*; D005006:Ethnicity / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D015994:Incidence; D009026:Mortality / Q000639:trends; D012044:Regression Analysis; D018426:SEER Program; D013997:Time Factors; D014481:United States / Q000453:epidemiology