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<INDICATOR name="BreCADth">
	<NAME>BreCADth</NAME>
	<DESCRIPTION>breast cancer, mammogram, mammography, cancer screening, females, women, breast cancer mortality, mortality</DESCRIPTION>
	<DEFAULT_INDICATOR_VIEW_NAME>BreCADth.Ut_USYear</DEFAULT_INDICATOR_VIEW_NAME>
	<TITLE>Breast Cancer Deaths</TITLE>
	<DEFINITION>The rate of death from cancer of the breast (ICD-10 C50) per 100,000 women.</DEFINITION>
	<NUMERATOR>The number of deaths due to breast cancer among women for a given time period (ICD-10 C50).</NUMERATOR>
	<DENOMINATOR>The female population of Utah or U.S. for a given time period.</DENOMINATOR>
	<DATA_NOTE>Codes used to define female breast cancer: ICD-10 C50.</DATA_NOTE>
	<DATA_SOURCE_DATE>03/26/2024</DATA_SOURCE_DATE>
	<WHY_IMPORTANT>Breast cancer is the most commonly occurring cancer in U.S. women (excluding skin cancers) and a leading cause of female cancer deaths in both Utah and the U.S. Nationally, deaths from lung cancer surpass deaths from breast cancer; however, breast cancer is the leading cause of cancer death among Utah women. Deaths from breast cancer can be substantially reduced if the tumor is discovered at an early stage. Mammography is currently the best method for detecting cancer early. Clinical trials and observational studies have demonstrated that routine screening with mammography can reduce breast cancer mortality by about 20% for women of average risk.^1^

Certain risk factors are linked to the development of breast cancer such as increased age, smoking, obesity, dense breast tissue, lower socioeconomic status, exposure to ionizing radiation, family history of breast cancer, BRCA 1 or BRCA 2 gene mutations, alcohol consumption, and hormonal influence over time. Some studies indicate that environmental contaminants such as benzene and organic solvents can also cause mammary tumors, but clear links have not been established.[[br]]
[[br]]
----
''1. Myers  ER, Moorman  P, Gierisch  JM,  et al.  Benefits and harms of breast cancer screening. JAMA. doi:10.1001/jama.2015.13183.''</WHY_IMPORTANT>
	<OTHER_OBJECTIVE_DESCRIPTION>CSTE Chronic Disease Indicators</OTHER_OBJECTIVE_DESCRIPTION>
	<HOW_DOING>The female breast cancer mortality rate in Utah has decreased slightly over time, from 21.8 deaths per 100,000 females in 1999 to 20.1 deaths per 100,000 females in 2022. Although the overall mortality rate has declined over the past two decades, trends in breast cancer mortality vary by different sociodemographic characteristics, including age, geography, and race/ethnicity. 

Examining trends in breast cancer mortality by different age groups reveals that the risk of breast cancer death increases significantly with age. For combined years 2018-2022 there were 203.2 deaths due to breast cancer per 100,000 women aged 85 years or older, the highest rate among all age groups. In comparison for the same time period, there were 38.8 deaths per 100,000 women aged 55-64, 60.5 deaths per 100,000 women aged 65-74, and 106.5 deaths per 100,000 women aged 75-84 attributed to breast cancer.

There are also differences in breast cancer mortality rates distributed geographically. From 2018 to 2022, Southeast Utah Local Health District had the highest breast cancer mortality rate of 23.2 deaths per 100,000 women, while Central Utah had the lowest rate with 16.0 deaths per 100,000 women (age-adjusted rates). Geographical distribution of breast cancer deaths can also be viewed in more detail at the Utah Small Area level (see additional data views). 

Differences in breast cancer death rates are also apparent for different racial and ethnic groups in Utah. For combined years 2018-2022, Hispanic women had a lower age-adjusted breast cancer mortality rate (15.5 deaths per 100,000 women) than non-Hispanic women (19.8 deaths per 100,000 women), though this was not a statistically significant difference. When looking at breast cancer mortality rates by race for the same time period, Asian women had significantly lower breast cancer death rates (7.5 deaths per 100,000 women) than all races combined (19.6 deaths per 100,000 women), while Native Hawaiian/Other Pacific Islander women had the highest breast cancer death rates (32.7 deaths per 100,000 women).</HOW_DOING>
	<STATE_VS_US>Since 1999, Utah on average has had a lower age-adjusted breast cancer mortality rate than the U.S. However, over the past decade the U.S. has demonstrated a downwards trend in breast cancer deaths, making it more aligned with the mortality rate in Utah.

In 2021, the latest year for which national incidence data are available, the U.S. breast cancer mortality rate was 19.4 per 100,000 females compared with the Utah rate of 19.6 per 100,000 females, though this was not a statistically significant difference.</STATE_VS_US>
	<WHAT_DOING>The Utah Breast &amp; Cervical Cancer Program (Utah B&amp;C) partners with local health departments, community clinics, hospitals and healthcare professionals to help those with low incomes who do not have adequate insurance gain access to timely breast and cervical cancer screening, diagnostic and treatment services. Eligible women can apply to Utah B&amp;C by calling 800-717-1811 or by submitting an online enrollment form available at: [https://cancerutah.org/do-i-qualify/].

The Utah Cancer Coalition a statewide partnership whose goal is to reduce the burden of cancer. The coalition works to lower cancer incidence and mortality in Utah through collaborative efforts directed toward cancer prevention and control. As a result of this planning process, objectives and strategies have been developed by community partners regarding the early detection of cervical, testicular, prostate, skin, breast, and colorectal cancers as well as the promotion of physical activity, healthy eating habits, and smoking cessation.</WHAT_DOING>
	<OTHER_PROGRAM_INFORMATION>In 1980, the Utah Department of Health and Human Services began providing clinical breast exams and a sliding fee scale. In 1993, state funding was appropriated for mammography. That same year, the Utah Breast and Cervical Cancer Program (Utah B&amp;C) first received a capacity-building grant from the Centers for Disease Control and Prevention (CDC) to conduct breast and cervical cancer screening in Utah. A comprehensive grant was awarded to the program in 1994 to continue breast and cervical cancer screening. Since 1994, Utah B&amp;C and partners, including local health departments, mammography facilities, pathology laboratories, and private providers, have worked together to ensure the appropriate and timely provision of clinical services.

Utah B&amp;C continues to receive funding from the CDC for breast and cervical cancer screening.</OTHER_PROGRAM_INFORMATION>
	<SERVICES_AVAILABLE_TO_PUBLIC>The Utah Breast &amp; Cervical Cancer Program (Utah B&amp;C) partners with local health departments, community clinics, hospitals, and healthcare professionals to help those with low incomes who do not have adequate insurance gain access to timely breast and cervical cancer screening, diagnostic and treatment services. Eligible women can apply to Utah B&amp;C by calling 800-717-1811 or by submitting an online enrollment form available at: [https://cancerutah.org/do-i-qualify/].</SERVICES_AVAILABLE_TO_PUBLIC>
	<RESOURCES_REFERENCES_LINKS>Utah Breast and Cervical Cancer Program @ [https://cancer.utah.gov/][[br]]
Utah Cancer Coalition @ [https://utahcancercoalition.org/][[br]]
Susan G. Komen Foundation @ [http://www.komen.org][[br]]
American Cancer Society @ [http://www.cancer.org][[br]]
National Cancer Institute @ [http://www.cancer.gov][[br]]
Huntsman Cancer Institute @ [https://healthcare.utah.edu/huntsmancancerinstitute/][[br]]
Centers for Disease Control and Prevention @ [http://www.cdc.gov][[br]]
American Society of Clinical Oncology @ [http://www.asco.org][[br]]
National Breast Cancer Coalition @ [http://www.natlbcc.org][[br]]</RESOURCES_REFERENCES_LINKS>
	<ORG_UNIT_NAME>CFHS_Cancer</ORG_UNIT_NAME>
	<OWNER_USER_ID>mnagata@utah.gov</OWNER_USER_ID>
	<STATUS_CODE>A</STATUS_CODE>
	<STATUS_DATE>04/12/2024</STATUS_DATE>
	<SORT_ORDER>3</SORT_ORDER>
	<ACTIVE_FLAG>x</ACTIVE_FLAG>
	<MODIFIED_DATE>04/12/2024</MODIFIED_DATE>
	<MODIFIED_DESCRIPTION>Status changed by: kimneerings@utah.gov</MODIFIED_DESCRIPTION>
	<PUBLISHED_DATE>04/12/2024</PUBLISHED_DATE>
	<HEALTHY_PEOPLE_OBJECTIVE>
		<MODIFIED_DATE></MODIFIED_DATE>
	</HEALTHY_PEOPLE_OBJECTIVE>
	<DATA_SOURCES/>
	<RELATIONS>
		<RELATION name="PopChar">
			<NAME>PopChar</NAME>
			<TITLE>Relevant Population Characteristics</TITLE>
			<TEXT>The risk of developing breast cancer increases with age. Having a family history of breast cancer may also increase the risk of developing cancer in one's lifetime.</TEXT>
			<RELATED_INDICATORS>
				<RELATED_INDICATOR>
					<NAME>AgeDistPop</NAME>
					<TITLE>Utah Population Characteristics: Age Distribution of the Population</TITLE>
					<DEFAULT_INDICATOR_VIEW_NAME>AgeDistPop.Ut_US</DEFAULT_INDICATOR_VIEW_NAME>
				</RELATED_INDICATOR>
				<RELATED_INDICATOR>
					<NAME>BreCAInc</NAME>
					<TITLE>Breast Cancer Incidence</TITLE>
					<DEFAULT_INDICATOR_VIEW_NAME>BreCAInc.UT_US</DEFAULT_INDICATOR_VIEW_NAME>
				</RELATED_INDICATOR>
				<RELATED_INDICATOR>
					<NAME>BreCAMam</NAME>
					<TITLE>Breast Cancer Screening (Mammography)</TITLE>
					<DEFAULT_INDICATOR_VIEW_NAME>BreCAMam.UT_US</DEFAULT_INDICATOR_VIEW_NAME>
				</RELATED_INDICATOR>
				<RELATED_INDICATOR>
					<NAME>CanDth</NAME>
					<TITLE>Cancer Deaths</TITLE>
					<DEFAULT_INDICATOR_VIEW_NAME>CanDth.UT_US</DEFAULT_INDICATOR_VIEW_NAME>
				</RELATED_INDICATOR>
				<RELATED_INDICATOR>
					<NAME>DthRat</NAME>
					<TITLE>Deaths From All Causes</TITLE>
					<DEFAULT_INDICATOR_VIEW_NAME>DthRat.UT_US</DEFAULT_INDICATOR_VIEW_NAME>
				</RELATED_INDICATOR>
				<RELATED_INDICATOR>
					<NAME>HHInc</NAME>
					<TITLE>Utah Population Characteristics: Household Income</TITLE>
					<DEFAULT_INDICATOR_VIEW_NAME>HHInc.UT_US</DEFAULT_INDICATOR_VIEW_NAME>
				</RELATED_INDICATOR>
				<RELATED_INDICATOR>
					<NAME>HlthIns</NAME>
					<TITLE>No Health Insurance Coverage</TITLE>
					<DEFAULT_INDICATOR_VIEW_NAME>HlthIns.UT_US_ACS</DEFAULT_INDICATOR_VIEW_NAME>
				</RELATED_INDICATOR>
				<RELATED_INDICATOR>
					<NAME>Pov</NAME>
					<TITLE>Utah Population Characteristics: Poverty, All Persons</TITLE>
					<DEFAULT_INDICATOR_VIEW_NAME>Pov.UT_US</DEFAULT_INDICATOR_VIEW_NAME>
				</RELATED_INDICATOR>
				<RELATED_INDICATOR>
					<NAME>RacEthPop</NAME>
					<TITLE>Utah Population Characteristics: Racial and Ethnic Composition of the Population</TITLE>
					<DEFAULT_INDICATOR_VIEW_NAME>RacEthPop.RaceYear</DEFAULT_INDICATOR_VIEW_NAME>
				</RELATED_INDICATOR>
			</RELATED_INDICATORS>
		</RELATION>
		<RELATION name="SystemFactors">
			<NAME>SystemFactors</NAME>
			<TITLE>Health Care System Factors</TITLE>
			<TEXT>According to data collected by the Utah Behavioral Risk Factor Surveillance System, use of mammography is lower among women without health insurance compared to women with health insurance. Screening mammography is a free preventive service mandated by the Affordable Care Act. The American Cancer Society currently recommends that women get a mammogram every year starting at age 45 (screening may be recommended earlier or more frequently depending on family cancer history).</TEXT>
			<RELATED_INDICATORS>
				<RELATED_INDICATOR>
					<NAME>BreCAMam</NAME>
					<TITLE>Breast Cancer Screening (Mammography)</TITLE>
					<DEFAULT_INDICATOR_VIEW_NAME>BreCAMam.UT_US</DEFAULT_INDICATOR_VIEW_NAME>
				</RELATED_INDICATOR>
				<RELATED_INDICATOR>
					<NAME>CosBarHtlhCar</NAME>
					<TITLE>Cost as a Barrier to Health Care</TITLE>
					<DEFAULT_INDICATOR_VIEW_NAME>CosBarHtlhCar.UT_US</DEFAULT_INDICATOR_VIEW_NAME>
				</RELATED_INDICATOR>
				<RELATED_INDICATOR>
					<NAME>HlthIns</NAME>
					<TITLE>No Health Insurance Coverage</TITLE>
					<DEFAULT_INDICATOR_VIEW_NAME>HlthIns.UT_US_ACS</DEFAULT_INDICATOR_VIEW_NAME>
				</RELATED_INDICATOR>
				<RELATED_INDICATOR>
					<NAME>PriProvUsuPl</NAME>
					<TITLE>Personal Doctor or Health Care Provider</TITLE>
					<DEFAULT_INDICATOR_VIEW_NAME>PriProvUsuPl.Age_Sex</DEFAULT_INDICATOR_VIEW_NAME>
				</RELATED_INDICATOR>
				<RELATED_INDICATOR>
					<NAME>RouMedCarVis</NAME>
					<TITLE>Routine Medical Care Visits</TITLE>
					<DEFAULT_INDICATOR_VIEW_NAME>RouMedCarVis.AgeSex</DEFAULT_INDICATOR_VIEW_NAME>
				</RELATED_INDICATOR>
			</RELATED_INDICATORS>
		</RELATION>
		<RELATION name="RiskFactors">
			<NAME>RiskFactors</NAME>
			<TITLE>Risk Factors</TITLE>
			<TEXT>The most important risk factor for breast cancer is increasing age. Other established risk factors include personal or family history of breast cancer, history of abnormal breast biopsy, genetic alterations, early age at onset of menses, late age at onset of menopause, never having children or having a first live birth at age 30 or older, and history of exposure to high dose radiation. Associations have also been suggested between breast cancer and oral contraceptives, long-term use of hormone replacement therapy, obesity and physical inactivity (in post-menopausal women), alcohol, and a diet high in fat. Some studies suggest that exercise in youth might give life-long protection against breast cancer and that even moderate physical activity as an adult could lower breast cancer risk. More research is needed to confirm these findings.</TEXT>
			<RELATED_INDICATORS>
				<RELATED_INDICATOR>
					<NAME>AlcConBinDri</NAME>
					<TITLE>Alcohol Consumption - Binge Drinking</TITLE>
					<DEFAULT_INDICATOR_VIEW_NAME>AlcConBinDri.UT_US</DEFAULT_INDICATOR_VIEW_NAME>
				</RELATED_INDICATOR>
				<RELATED_INDICATOR>
					<NAME>AlcConChrDri</NAME>
					<TITLE>Alcohol Consumption - Heavy Drinking</TITLE>
					<DEFAULT_INDICATOR_VIEW_NAME>AlcConChrDri.UT_US</DEFAULT_INDICATOR_VIEW_NAME>
				</RELATED_INDICATOR>
				<RELATED_INDICATOR>
					<NAME>Obe</NAME>
					<TITLE>Obesity Among Adults</TITLE>
					<DEFAULT_INDICATOR_VIEW_NAME>Obe.UT_US</DEFAULT_INDICATOR_VIEW_NAME>
				</RELATED_INDICATOR>
				<RELATED_INDICATOR>
					<NAME>OvrwtObe</NAME>
					<TITLE>Overweight or Obese</TITLE>
					<DEFAULT_INDICATOR_VIEW_NAME>OvrwtObe.UT_US</DEFAULT_INDICATOR_VIEW_NAME>
				</RELATED_INDICATOR>
				<RELATED_INDICATOR>
					<NAME>PhysAct</NAME>
					<TITLE>Physical Activity: Recommended Aerobic Activity Among Adults</TITLE>
					<DEFAULT_INDICATOR_VIEW_NAME>PhysAct.UT_US</DEFAULT_INDICATOR_VIEW_NAME>
				</RELATED_INDICATOR>
				<RELATED_INDICATOR>
					<NAME>PhysActAdol</NAME>
					<TITLE>Physical Activity Among Adolescents</TITLE>
					<DEFAULT_INDICATOR_VIEW_NAME>PhysActAdol.Sex.Year</DEFAULT_INDICATOR_VIEW_NAME>
				</RELATED_INDICATOR>
			</RELATED_INDICATORS>
		</RELATION>
		<RELATION name="HealthStatus">
			<NAME>HealthStatus</NAME>
			<TITLE>Health Status Outcomes</TITLE>
			<TEXT>Finding breast cancer early through the use of the preventive screening mammography is one of the most important strategies to prevent deaths from breast cancer. Receiving regular mammograms is important to find breast cancer early in order to more successfully treat is. Screening mammography is a free preventive service mandated by the Affordable Care Act.</TEXT>
			<RELATED_INDICATORS>
				<RELATED_INDICATOR>
					<NAME>BreCAMam</NAME>
					<TITLE>Breast Cancer Screening (Mammography)</TITLE>
					<DEFAULT_INDICATOR_VIEW_NAME>BreCAMam.UT_US</DEFAULT_INDICATOR_VIEW_NAME>
				</RELATED_INDICATOR>
				<RELATED_INDICATOR>
					<NAME>CanDth</NAME>
					<TITLE>Cancer Deaths</TITLE>
					<DEFAULT_INDICATOR_VIEW_NAME>CanDth.UT_US</DEFAULT_INDICATOR_VIEW_NAME>
				</RELATED_INDICATOR>
			</RELATED_INDICATORS>
		</RELATION>
	</RELATIONS>
	<INDICATOR_VIEWS>
		<INDICATOR_VIEW>
			<NAME>BreCADth.Ut_USYear</NAME>
			<TITLE>Breast Cancer Deaths</TITLE>
			<SUB_TITLE>by Year, Utah and U.S.,</SUB_TITLE>
			<PERIOD_TITLE>1999-2022</PERIOD_TITLE>
			<Y_TITLE>Age-adjusted Death Rate per 100,000 Women</Y_TITLE>
		</INDICATOR_VIEW>
		<INDICATOR_VIEW>
			<NAME>BreCADth.Age</NAME>
			<TITLE>Breast Cancer Deaths</TITLE>
			<SUB_TITLE>by Age Group, Utah,</SUB_TITLE>
			<PERIOD_TITLE>2018-2022</PERIOD_TITLE>
			<Y_TITLE>Deaths per 100,000 Women</Y_TITLE>
		</INDICATOR_VIEW>
		<INDICATOR_VIEW>
			<NAME>BreCADth.LHD</NAME>
			<TITLE>Breast Cancer Deaths</TITLE>
			<SUB_TITLE>by Local Health District, Utah,</SUB_TITLE>
			<PERIOD_TITLE>2018-2022</PERIOD_TITLE>
			<Y_TITLE>Age-adjusted Rate per 100,000 Women</Y_TITLE>
		</INDICATOR_VIEW>
		<INDICATOR_VIEW>
			<NAME>BreCADth.SA</NAME>
			<TITLE>Breast Cancer Deaths</TITLE>
			<SUB_TITLE>by Utah Small Area,</SUB_TITLE>
			<PERIOD_TITLE>2018-2022</PERIOD_TITLE>
			<Y_TITLE>Age-adjusted Rate per 100,000 Women</Y_TITLE>
		</INDICATOR_VIEW>
		<INDICATOR_VIEW>
			<NAME>BreCADth.Eth</NAME>
			<TITLE>Breast Cancer Deaths</TITLE>
			<SUB_TITLE>by Ethnicity, Utah,</SUB_TITLE>
			<PERIOD_TITLE>2018-2022</PERIOD_TITLE>
			<Y_TITLE>Age-adjusted Rate per 100,000 Women</Y_TITLE>
		</INDICATOR_VIEW>
		<INDICATOR_VIEW>
			<NAME>BreCADth.Race</NAME>
			<TITLE>Breast Cancer Deaths</TITLE>
			<SUB_TITLE>by Race, Utah,</SUB_TITLE>
			<PERIOD_TITLE>2018-2022</PERIOD_TITLE>
			<Y_TITLE>Age-adjusted Rate per 100,000 Women</Y_TITLE>
		</INDICATOR_VIEW>
	</INDICATOR_VIEWS>
</INDICATOR>
