Northern California Cancer Center Releases Breast Cancer Incidence and Mortality Rates in the Bay Area
Marin Breast Cancer Watch Statement in Response to the Rate Release
(San Rafael, September 15, 2004). Marin Breast Cancer Watch has carefully reviewed the long awaited analysis of the breast cancer incidence and mortality rates in Marin County and the Bay Area that the Northern California Cancer Center has worked so diligently to produce.
However, as we review this data, it is important to keep in mind the larger picture. Although there was a recent two-year decrease in the incidence rates of invasive breast cancer in Marin County, over time the rates have continued to increase. During the twelve-year period of 1988 to 2001, the rates of invasive breast cancer increased 12.4% in Marin County, nearly double the state wide average. During the same period of time, the rates of invasive breast cancer remained the same in San Francisco County.
As a community, we have always known that breast cancer incidence rates among white non-Hispanic women are higher in Marin County, but we have never had any information about incidence trends among women of other ethnic groups. This report confirms that the incidence rate for Hispanic women is also higher in Marin, more than anywhere else in Bay Area. This is particularly noteworthy because it is the first time our community has had any information on breast cancer trends among African-American, Hispanic or Asian/Pacific Islander women.
There is important information that is missing from this report because it is not collected or analyzed. For example, we still don’t know what the relapse rates are for breast cancer in Marin County or the Bay Area. We also don’t know the breast cancer survival trends. Marin Breast Cancer Watch in partnership with the Kaiser Permanente Division of Research, is beginning to investigate breast cancer relapse and survivorship.
This report not only highlights the elevated rates of breast cancer, but prostate and uterine cancer as well. Clearly we need more information on the possible connections and causes of these cancers- be they genetic, hormonal or environmental. Let us not grasp on to any one theory. For example, some believe that the use of hormone replacement therapy (HRT) explains the high rates of breast cancer in Marin County. Prostate cancer rates are comparable. How many men are taking HRT?
The work of the Bay Area Breast Cancer and the Environment Research Center is critically important to understanding the complex role environmental factors play in the development of breast cancer. Marin Breast Cancer Watch, UCSF Comprehensive Cancer Center, Kaiser Permanente Division of Research, county public health departments and breast cancer advocates are combining efforts in this unique bay area and national study.
Everyday we are reminded that breast cancer has a major impact on the lives of women and their families living in Marin and throughout the Bay Area. These new rates simply show that the geographical area of concern has widened to include San Francisco. In fact, breast cancer in the Bay Area is a much larger problem than previously reported. Which Bay Area County will be next? Even more than ever, we need to re-double our efforts to find out why this is happening. Marin Breast Cancer Watch firmly believes that the solution lies in forging new directions in community based research, education and advocacy.
Marin Breast Cancer Watch to Partner with the National Institute of Environmental Health Sciences
Marin Breast Cancer Watch to Lead Community Outreach Core for New Bay Area Research Center
(San Rafael, Calif., October 14, 2003) – The Bay Area will be home to a new breast cancer research center and Marin Breast Cancer Watch (MBCW), a leading community-based research organization, will be the lead agency charged with communicating research findings with the community.
The Bay Area Breast Cancer and the Environment Research Center is one of four research centers being awarded around the country by the National Institute of Environmental Health Sciences (NIEHS) and the National Cancer Institute (NCI) to investigate potential environmental factors that could lead to breast cancer.
The Center is a collaborative effort among Bay Area institutions, researchers, scientists and advocacy groups to harness the expertise in the region and work together to better understand the causes of breast cancer and what can be done to prevent it.
One of the strengths of the Center will be the commitment to communicate its efforts with the local community. Marin Breast Cancer Watch will lead the Community Outreach and Translational Core (COTC), which seeks to facilitate two-way communication between scientists and the community.
“One of the priorities of our organization is to make sure that scientists understand the concerns of the community. We want to ensure that research is translated in a way that people can understand,” said Janice Barlow, Executive Director of MBCW and head of the COTC. “The more people know about the research process, the more they can influence future studies and make their voices heard.”
The effort to a secure a Center in the Bay Area started last year after Marin Breast Cancer Watch co-hosted a town hall meeting with the UC Berkeley NIEHS Center titled: “Voices for a Healthy Community: Breast Cancer and the Environment.” The town hall created a dialogue between scientists and the community on breast cancer, identified areas of future breast cancer research, and created opportunities for further collaboration among cancer groups, concerned health professionals, scientists, public policy advocates, government officials and community members.
At the town hall, NIEHS Director Dr. Kenneth Olden announced the agency would award funding for centers in the coming year. A Bay Area group soon formed and began drafting a proposal. Shortly thereafter, Rep. Lynn Woolsey (D-Calif.) helped secure a commitment from four federal health agencies to study Marin County’s breast cancer rate and allocate resources for the effort.
The Research Center and the other centers in a national network supported by the NIH will focus attention on adolescence, a vulnerable period of breast development thought to play a critical role in the future development of breast cancer.
Marin County has one of the highest breast cancer incidence rates in the country. According to the Northern California Cancer Center, there was a 37% increase in breast cancer incidence in Marin County from 1990-1999, while there was a less than 5% increase in other parts of California during the same time.
Initially, there will be two main areas of research focus. One project will study how the developmental steps of the mammary gland and use mouse models to test the effects of exposure to potential environmental stressors. The second project will be to conduct an epidemiological study of the determinants of puberty in girls. Attention will be paid to understanding the shift toward earlier puberty among adolescent girls, the identification of environmental exposures in young girls, and the interplay between genetic polymorphisms and environmental exposures that may put them at risk for future breast cancer.
The BABCERC has a broad group of collaborators, including the University of California, San Francisco; Lawrence Berkeley National Laboratories; Kaiser Permanente; California DHS; Marin Breast Cancer Watch; San Francisco DHHS; the Marin County Health Department; and Roswell Park Cancer Institute.
A grant from the Avon Foundation allowed MBCW to dedicate the time and resources necessary to write the COTC portion of the Center proposal. The other three sites being awarded are at the Fox Chase Cancer Center in Philadelphia, Michigan State University in Lansing, and the University of Cincinnati.
Marin Breast Cancer Watch Publishes First Research Study
Group Announces Plans to Create Adolescent Education Program
(San Rafael, Calif., May 5, 2003) – Marin Breast Cancer Watch, a non-profit grassroots organization, announced today the results from its first research project, the Adolescent Risk Factors Study (ARFS), have been published in the scientific journal Breast Cancer Research.
The study can be found online at: http://breast-cancer-research.com/content/5/4/R88.
Completion of the study marks the conclusion of the first community-based research study in the Bay Area to look at breast cancer.
“This is an important step forward because it shows that the community can not only be a part of the research process, but be part of helping find the causes of breast cancer,” said Janice Barlow, executive director of Marin Breast Cancer Watch. “Publication of this study is just one more piece of the puzzle as we try to understand what is causing breast cancer.”
In 1997, members of Marin Breast Cancer Watch sought help from researchers and scientists to help them better understand the causes of breast cancer in Marin. Dr. Margaret Wrensch, PhD, a Professor of Epidemiology and Biostatistics at the University of California, San Francisco, answered the call and helped the community organization devise the Adolescent Risk Factors Study. At the time, there was very little research into how the experiences of adolescents might affect their chances of getting breast cancer later in life.
The Adolescent Risk Factors Study was designed to understand if adolescent and pre-adolescent exposures and experiences differ between women with and without breast cancer in Marin County.
Trained interviewers individually interviewed approximately 300 Marin County women diagnosed between July 1, 1997 and June 30, 1999 with breast cancer (cases), and 300 Marin County women without breast cancer (controls), matched for age and ethnicity.
Results of the study found striking similarities between the cases and controls as well as several differences that were significant. Lifetime number of years lived in Marin was 24.2 years for both groups and the mean age first lived in Marin was 28.8 for controls and 29.6 for cases. Other factors that were not significantly different between cases and controls included: having a first degree relative with breast cancer (20% of controls and 18 % of cases); history of non-cancerous breast biopsy; current socioeconomic status; age of first period; age at first birth or pregnancy (mean of 25.1 for controls and 25.3 for cases); use of hormone replacement therapy; height; health insurance status; and frequency of pelvic exams and pap tests.
Significant differences were noted in other factors. Cases were more likely than controls to report: a high socioeconomic status before the age of 21; four or more mammograms in 1990-1994; giving birth without breast feeding; being premenopausal; never having used birth control pills; having a lower highest body mass index; beginning drinking after age 21; drinking on average two or more drinks per day; and being raised in an organized religion.
The similarities between cases and controls in this study, and the high incidence of some breast cancer risk factors that were found in many areas, suggest that both groups are at high risk for breast cancer. Specific findings, in combination with the results of other recent prospective studies, suggest that decreased alcohol consumption and increased breastfeeding after childbirth, modifiable risk factors in adults, might help to reduce breast cancer risk.
“This research project was initiated due to community concerns.” Barlow continued. “Early in the process, meetings composed of community members were held to help focus research direction and techniques. At every step in the process, MBCW research members have played an active role.”
The principal investigators on the study were Margaret Wrensch, Ph.D, and Georgianna Farren, MD, representing Marin Breast Cancer Watch.
The focus on community-based research as a model has established Marin Breast Cancer Watch as a leading advocate for community concerns and ideas in research projects.
In continuing its leadership role in Marin, Marin Breast Cancer Watch also announced the creation of a new education outreach program aimed at adolescent girls, the “Adolescent Breast Cancer Education and Prevention Program.”
The new initiative will take the information learned from the Adolescent Risk Factors Study, and results from other adolescent breast cancer studies, and create an education program that gives young girls the information and tools they need to make informed decisions about their health.
Barlow said the program is currently being developed and interested members of the community are welcome to participate in the process. The first step in creating the program is to conduct a community wide assessment about the current state of health education in Marin County regarding health risk, adolescent health and breast cancer. Then the group will host a series of focus groups with young girls and mothers to learn where breast cancer fits into the agenda of teenage girls in Marin. Finally, an evaluation of other programs around the country will be made to help determine tools and information that may be helpful in Marin.
“The idea for this program came from discussions with women in the community who want to make sure their daughters have information about breast cancer and health,” Barlow said. “There is a real need to not only inform, but to work with young people to better understand their concerns and ideas.”
Working with health care professionals, educators, young girls and others from the community, Marin Breast Cancer Watch hopes to create a pilot program that can be a model for other communities.
Marin Breast Cancer Watch is a grassroots, non-profit organization dedicated to finding the causes and stopping the epidemic of breast cancer. The organization accomplishes its mission through community-based participatory research, education and public policy advocacy with a focus on creating a healthy environment.