ArticleFrontiers in oncology2026
Trends and disparities in breast cancer mortality among older adults in the United States, 1999-2020.
Article in Frontiers in oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Breast cancer remains a major cause of cancer mortality among older adults in the United States. Although overall breast cancer mortality has declined in recent decades, the extent to which these improvements have been shared across demographic and geographic subgroups among adults aged 65 years and older remains insufficiently characterized. Methods: We conducted a population-based repeated cross-sectional mortality analysis using the CDC WONDER Underlying Cause of Death database from 1999 to 2020. Deaths due to breast cancer among U.S. adults aged 65 years and older were defined using ICD-10 code C50 as the underlying cause of death. Age-adjusted mortality rates (AAMRs) and age-specific crude mortality rates were calculated. Female-specific AAMRs were used as the primary outcome for demographic, geographic, state-level SDI panel, and descriptive frontier analyses; male breast cancer mortality was reported separately as a descriptive finding. Temporal trends were assessed using Joinpoint regression. Results: From 1999 to 2020, 544,812 deaths due to breast cancer occurred among U.S. adults aged 65 years and older, including 538,489 deaths among women and 6,323 among men. The pooled female-specific AAMR was 99.84 per 100,000 women, compared with 1.70 per 100,000 men. Among older women, mortality increased with age, was highest among Black or African American women, and varied substantially across regions and jurisdictions. The combined-sex AAMR declined from 71.58 to 50.83 per 100,000 population, although the decline slowed after 2014. State-level analyses showed marked geographic and sociodemographic variation in female breast cancer mortality. Conclusions: Breast cancer mortality among older U.S. adults declined significantly between 1999 and 2020, but the increasing absolute number of deaths and persistent age, racial, ethnic, and geographic disparities indicate a continuing public health burden. Targeted strategies to improve equitable access to screening, timely diagnosis, guideline-concordant treatment, and geriatric oncology care are needed to further reduce mortality among older adults.
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