Geographic variation in breast cancer mortality for white and black women:1986-1995

Breast cancer mortality rates have decreased during the last 20 years in th e United States overall. However, declines in breast cancer mortality rates differ among individual states. This analysis ranked states from the highe st to the lowest percentage change in mortality between 1986 to 1990 and 19 91 to 1995. Data on white and black females were analyzed separately. Among white women, the 10 states showing the greatest percentage change in morta lity during those two periods had the greatest baseline mortality in the 19 86-to-1990 period. Similarly, the 10 states with the lowest percentage chan ge in mortality had the lowest mortality rate in 1986 to 1990. In contrast, among black women, the top 10 states ranked by percentage change in mortal ity included either a decline or an increase. The disparities in mortality rates by state likely depend on the stage of disease at diagnoses, socioeco nomic status, access to care, and adequacy of medical care.