Breast cancer deaths decrease as cases among Asian Americans and younger adults rise, new report finds
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(NEW YORK) — Breast cancer deaths have fallen by 44% compared to 35 years ago, saving nearly 520,000 lives, according to a new report by the American Cancer Society.
The dramatic decrease is a major milestone in the fight against breast cancer, according to Dr. Lisa Newman, a co-author of the report, released on Tuesday, the start of Breast Cancer Awareness Month.
“This decline is evidence of our success in better treatments for breast cancer, especially with targeted treatments,” Newman, chief of the section of breast surgery at NewYork-Presbyterian/Weill Cornell Medical Center, told ABC News.
Beyond advances in care, Newman noted that mammography has also played a crucial role in detecting cancer earlier.
In April, the U.S. Preventive Services Task Force updated their guidelines, recommending that women at average risk for breast cancer get a mammogram every two years starting at age 40.
However, screening isn’t perfect, Newman stressed.
Women should watch for new lumps, skin changes, and nipple changes, including unusual discharge, pain, and redness.
Even if the last mammogram is clear, women should discuss any changes with a healthcare provider.
Steepest rise in new cases among women under 50
Though breast cancer deaths have dropped, new cases continue to rise.
From 2012 to 2021, breast cancer diagnoses increased by 1% each year, with the steepest rise among women under 50.
The reasons for the increase in diagnoses at a younger age remain unclear, Newman said.
“We speculate that it is related to differences in lifestyle and environment given the obesity epidemic and more women delaying their childbearing years and having fewer pregnancies over their lifetime,” she said.
Racial disparities in breast cancer persist
Yet despite lower overall death rates, racial disparities in breast cancer persist.
American Indian and Alaska Native (AIAN) women have seen no improvement in death rates, while Asian American/Pacific Islander (AAPI) women face the fastest uptick in new cases, with a nearly 3% annual increase.
And despite having 10% fewer cases than white women, AIAN women are 6% more likely to die from the disease and receive fewer regular mammograms.
Black women face a 38% higher chance of dying from breast cancer and have worse outcomes at every stage and subtype, except for localized cancers, compared to white women.
“Studies show that Black women are more likely to receive mammograms at lower-quality facilities, face delays in diagnosing abnormalities, and experience delays in starting and completing treatment,” Newman explained.
Because African American women are more prone to triple negative breast cancer, a particularly deadly form of the disease, Newman said there is a strong push to improve the diversity in clinical trials.
In May of 2024, the ACS launched the VOICES of Black Women Study which will enroll 100,000 Black women aged 25 to 55 and follow them for 30 years.
Newman also pointed out that breast cancer can affect men, especially African American men, who have double the risk compared to White men.
While the report revealed many promising trends in breast cancer, the disease remains the second most common cancer among women in the U.S. after skin cancer and the leading cause of cancer deaths for Black and Hispanic women. In 2024, experts predict over 300,000 new invasive (stage I and above) breast cancer cases with more than 40,000 deaths.
The report’s findings are based on data from the national cancer tracking programs that includes information from the National Cancer Institute and the Centers for Disease Control and Prevention.
Sara Anne Willette and her family plan on moving to the countryside in the South as COVID-19 continues to impact the immunocompromised community. — Courtesy of Sara Anne Willette
(NEW YORK) — Sara Anne Willette has spent more than 1,620 days in isolation since the start of the COVID-19 pandemic.
The New Jersey resident took health precautions in public before the pandemic because of her common variable immunodeficiency, which means she doesn’t make enough antibodies to fight infections.
Simple tasks like going for a walk down the street or taking a trip to the grocery store are laden with safety hurdles and anxiety for Willette.
Stressful tasks, like moving from Iowa to New Jersey during the pandemic for her husband’s new job, are now even more taxing. The two drove overnight to avoid crowds at gas stations and rest stops, and she’s prepared to do it again. The substantial health precautions in her day-to-day life are forcing her and her family to pack up their life once more and look for a new home in the countryside.
“I’m angry that society is largely inaccessible and I have to risk my life for the bare minimum, like medical care,” Willette told ABC News in a phone call. “Why live in civilization if all of it is completely inaccessible?”
More than four years after the start of the COVID-19 pandemic, Willette is among the immunocompromised and disabled Americans who’ve complete changed their way of living to survive.
Her anger was tinged with disappointment as she talked about how the rest of the world has gone back to normal despite the hundreds of people across the country dying from COVID-19 each week amid a summer surge of the virus.
COVID-19 has also been a debilitating event for tens of millions of people who have or are currently experiencing long COVID, which in some cases has been defined as a disability under the Americans with Disabilities Act.
With some lawmakers beginning to propose mask bans in hopes of reducing crime, it’s no longer an option for some to live life normally among the rest of society.
Willette was among the people ABC News checked back in with after previously talking to them about isolating two years after the pandemic began.
Finding a new normal
There are simple joys that Willette misses: having a garden, running, walking, letting her dogs run without a leash and drinking coffee on a porch.
She’s planning on moving to the mountains — somewhere between New Hampshire and Virginia — and gaining enough acreage to allow her and her family to embrace the activities they lost during the pandemic. However, being alone out in the countryside isn’t the goal for Willette.
Rather, she intends to build a pathogen-aware community. That means buying enough land so other disabled, immunocompromised or health-conscious able-bodied people who don’t want to get COVID-19 can join them and create a home of their own.
“We want something that feels like normal but is set up in a way that we decrease harm for everyone in the community,” Willette said. “We can’t do that in an urban area or even in a suburban area. There are too many risks.”
Her mother and mother-in-law intend to move and join Willette, her husband and her son on the property as well.
For Charis Hill, a California resident who has a systemic inflammatory disease and takes immunosuppressive medications, it’s been hard to access an in-person doctor’s appointment since many safety precautions for COVID-19 are no longer being taken in medical care facilities.
As someone with “high-level medical needs,” the lack of COVID precautions has even made seeking routine care a challenge.
“Just the fact that a medical environment that is supposed to know what a virus can do, most medical environments no longer require masking, and that’s what makes it unsafe for people like me to go, for anybody to go,” Hill told ABC over the phone.
“The impact of the delayed care, where people can’t go get routine care, that’s going to affect the whole health care system. Emergencies happen because of delayed care.”
Despite the stress and forced isolation, they find moments of joy growing their own food in their garden, and stay busy by working to reduce the local feral cat population through Trap-Neuter-Return practices.
They break their isolation monthly to meet at a park with a close-knit circle of friends who take similar safety precautions — they’re all masked, socially distanced and have tested beforehand.
“That’s really the only way for me to meet strangers and also to make new friends,” Hill said.
Mask bans would further bar immunocompromised people from public life, according to Hill.
Such bans “make it unsafe for us to exist,” Hill noted, because people may feel pressure not to wear masks when they’re sick or if immunocompromised people are worried about backlash for doing so.
With more people testing positive for COVID this summer, and with the fall and winter virus season ahead, Hill says society’s “new normal” should involve free testing, vaccines, access to at-home antiviral therapy paxlovid and flexible hybrid working options to mitigate the spread of illnesses.
“We need a new normal, and a new normal that is equitable for everyone, and that not only prioritizes high risk people, but that also reduces infection overall,” Hill said.
COVID concerns for the immunocompromised population
Immunocompromised people — about 3% of the adult population in the U.S., according to the National Institutes of Health — continue to face potentially serious medical complications or death when it comes to COVID-19. Even for those who were not previously at risk now have seen life-changing heath impacts.
“Long COVID can happen to anyone, and I have certainly seen young, healthy, vigorous athletes have prolonged, debilitating symptoms from long COVID,” Dr. Jeannina Smith, the medical director of University of Wisconsin’s Transplant Infectious Disease Program, told ABC over the phone.
However, society has largely appeared to have moved on. The CDC stopped recording some COVID-19 related data and some politicians have proposed mask bans as a potential solution to crime.
“It takes us a step back for public health,” Hill said. “We have other pandemics that are coming, and it’s going to make it harder to reenact mask mandates if we need them in the future.”
For the immunocompromised, regular society could seem like a minefield, according to Dr. Cassandra M. Pierre, the medical director of Public Health Programs and the associate hospital epidemiologist at Boston Medical Center.
She noted that people at higher risk for complications “are still, unfortunately, in our hospitals today. We see that they have this forced risk of going on to develop critical COVID or potentially even die. This is still occurring. COVID is still happening.”
This is all happening despite a better understanding of disease transmission and the information needed to be better equipped to empower communities to protect their health, Pierre added.
Patients have been harassed or mocked for wearing masks in public, Dr. Jeannina Smith noted, despite international and national medical organizations emphasizing the importance of mask wearing as a mitigation tactic for illnesses. Hill has experienced this first hand.
“You can’t look at someone and know that they’re receiving immunosuppression for an organ transplant or an autoimmune condition, and they remain at risk,” Smith said.
“Even if you don’t have individual risk, any person can still spread COVID to someone who has higher risk,” she said. “In fact, much of the spread continues to be from asymptomatic person. The very idea that we would criminalize wanting to protect our fellow citizens is pretty horrific.”
The federal government has recently changed its tune amid the summer COVID spike and is preparing for the upcoming fall and winter season by approving and granting emergency use authorization for updated COVID-19 vaccines and restarting its free at-home COVID tests program.
(WASHINGTON) — Former New York Gov. Andrew Cuomo began his public testimony before Congress on Tuesday by defending his administration’s nursing home policies during the early days of the COVID-19 pandemic.
The hearing, before the Republican-led House Oversight and Accountability Select Subcommittee on the Coronavirus Pandemic, addressed Cuomo’s decision to allow COVID-19-positive patients back into nursing homes and long-term care facilities while the pandemic was underway.
Cuomo previously testified before the subcommittee during a closed-door hearing in June.
“The U.S. Centers for Disease Control and Prevention, the CDC on March 13, 2020, [Centers for Medicare & Medicaid Services] CMS issued guidance — let us trust the word ‘guidance’ — that specifically directed nursing homes to not accept COVID-19-positive patients if they were unable to do so safely and to only accept individuals if the nursing home could follow CDC transmission based guidance,” subcommittee Chairman Rep. Brad Wenstrup, R-Ohio, said in his opening statement on Tuesday.
In March 2020, as COVID-19 cases were surging, Cuomo issued an order requiring nursing homes to readmit all residents who were “medically stable” and returning after being hospitalized for the virus.
“No resident shall be denied re-admission or admission to the [nursing home] solely based on a confirmed or suspected diagnosis of COVID-19,” the order read. It further stated that nursing homes were “prohibited from requiring a hospitalized resident who is determined medically stable to be tested for COVID-19 prior to admission or readmission.”
However, Cuomo responded that the CMS and CDC, under the administration under former President Donald Trump, advised that “that COVID-positive people could go from hospitals to nursing homes, even if they were still infectious. That was your ruling.”
“‘The March 25 guidance was consistent with the CMS guidance. The March 25 guidance was consistent with the CMS guidance if nursing homes have the ability to adhere to infection prevention and control recommendations.’ That’s the attorney general’s position opinion,” Cuomo said, referring to New York Attorney General Letitia James.
At the time of the directive, Cuomo explained that the order would help expand hospital capacity to meet the demands of caring for the sickest COVID-19 patients. After facing criticism from nursing home advocates, however, the governor amended the order in May 2020, prohibiting hospitals from discharging patients to nursing homes unless they first tested negative for COVID-19.
“The March 25 directive was dubbed a ‘must admit order’ by the public and press, and rightfully so,” Wenstrup said, addressing the former New York governor. “Your directive was not consistent with federal guidance, nor consistent with medical doctrine. You do not put highly contagious patients in with vulnerable patients. subject to infection, and in this case death.”
Cuomo fought back against criticism of his policies and, in July 2020, a report from the New York State Department of Health (NYSDOH) stated that COVID-19 was introduced into nursing homes by infected staff, and that peak staff infections correlated with peak nursing home resident deaths. The report also found that “admissions policies were not a significant factor in nursing home fatalities.”
However, in January 2021, New York Attorney General Letitia James released a report that found the NYSDOH had undercounted the number of nursing home residents who died of COVID-19 by as much as 50%, and failed to count in its official death tally nursing home residents who died of COVID-19 after being admitted to hospitals.
In total, more than 15,000 nursing home residents in New York died of COVID-19.
In 2022, Cuomo’s representative said the Manhattan District Attorney’s office would not file criminal charges in connection with the former governor’s handling of nursing home deaths during the pandemic.
Earlier this year, an independent investigation, commissioned by current New York Gov. Kathy Hochul, found that although Cuomo’s nursing home response policy was based on “the best available data at the time,” communication to the public was poor and caused anxiety for family members of nursing home residents.
“Even the most well-intentioned policy had unforeseen consequences in [New York state] nursing homes,” the report read.
(NEW YORK) — Deaths from dementia have tripled in just 21 years, according to a new study published in The Primary Care Companion for CNS Disorders.
In 1999, about 150,000 Americans died from dementia, according to the study. By 2020, that number had tripled to over 450,000.
The chances of dying from dementia increased among every demographic group studied, according to study author Mohsan Ali, a physician with the King Edward Medical University in Pakistan.
Tripling of dementia deaths
Dementia is defined by the National Institute on Aging as “the loss of cognitive functioning — thinking, remembering, and reasoning — and behavioral abilities to such an extent that it interferes with a person’s daily life and activities.” The reason it is increasingly the cause of death could be because people are living longer or getting diagnosed earlier, according to Ali.
“Age is the most significant risk factor for dementia,” Ali said. However, the increased prevalence of chronic conditions such as heart disease, diabetes, and obesity may also be contributing factors, he added.
Women, Black adults, and people living in rural communities showed the greatest increase in dementia deaths, the study found.
“While the increased rates in women may be because women live longer than men, there may be biological and genetic factors that make women more susceptible to dementia,” Ali noted. “Rural areas face a higher burden of dementia-related mortality due to several factors. These include limited access to healthcare services, fewer specialists in dementia care, and reduced availability of support services.”
Black adults had the highest death rate, followed by non-Hispanic white adults, and then Hispanic adults.
Fresh insights on dementia prevention
By 2050, the number of people with dementia will double in the U.S. to over 10.5 million and triple globally to over 150 million, the British medical journal The Lancet forecast in 2022. Yet despite these alarming statistics, experts say the average person has some control over their cognitive health.
“I am most excited about advances in dementia prevention, because we are learning about a number of lifestyle modifications that are both accessible to most of us and effective,” Leah Croll, MD, neurologist at Maimonides Health in New York, told ABC News.
Up to 45% of dementia cases may be preventable by addressing 14 modifiable risk factors, according to the Lancet Commission on Dementia.
Lifestyle factors that increased the chances of a dementia diagnosis include less education, head injury, physical inactivity, smoking, excessive alcohol consumption, high blood pressure, obesity, diabetes, high cholesterol, hearing loss, depression, social isolation, vision loss, and exposure to air pollution in older life.
“Staying up-to-date with your primary care visits, being diligent about your medications pays dividends over and over for your brain health,” Croll emphasized.
Dementia diagnosis and treatment today
Early detection and diagnosis is key to addressing dementia, according to experts.
Dementia is generally diagnosed with a combination of cognitive testing, brain imaging, and sampling the cerebrospinal fluid (CSF) that surrounds the brain and spinal cord and checking it for levels of dementia-related proteins.
Because some of these tests may not be readily available in some areas and can be expensive, researchers have been working on more accessible screening methods. For example, a recent study found that a blood test for Alzheimer’s disease, which is the most common type of dementia, may be as accurate at detecting Alzheimer disease as CSF sampling. However, the blood test is still in early phases of study.
In addition to ongoing research for diagnostics, there are new FDA-approved treatments for early Alzheimer’s dementia, when the symptoms are still relatively mild.
“Right now, it seems that these drugs modestly slow down the progression of disease, but they do not stop it, so it’s unclear how they will impact morbidity and mortality,” Croll cautions.
Overall, Croll believes that patients and families affected by dementia should feel hopeful about the future: “In many ways, dementia is one of the final frontiers in medicine, and we are finally starting to crack the code,” she said.
Noor Shaik, MD, PhD, is a neurology resident physician and a member of the ABC News Medical Unit.
