Breast Cancer Deaths Drop In U.S., But Global Gaps Continue To Grow

Forbes

19-05-2025

In high-income countries, breast cancer survival rates have steadily improved.
Breast cancer is the most commonly diagnosed cancer in women worldwide. In high-income countries, survival rates have steadily improved, but that is only part of the story. A recent study from the American Association for Cancer Research highlights both progress and persistent inequality in the fight against breast cancer.
According to the study, breast cancer mortality in U.S. women aged 20 to 49 dropped significantly between 2010 and 2020. The decline was seen across all types of breast cancer and affected women of all ethnic and socioeconomic backgrounds. But even with this overall improvement, stark disparities remain. In 2020, non-Hispanic Black women still had the highest mortality rate—3.41 deaths per 100,000, compared to 1.16 per 100,000 among non-Hispanic White women. Breast cancer is less common in Hispanic women, but according to the American Cancer Society, they are also screened less. When diagnosed, the condition is therefore more advanced and tends to be more aggressive.
The decline in death rates is particularly noteworthy because breast cancer incidence has been rising, not falling. More women are being diagnosed with the disease than a decade ago. The authors of the study point to improved treatments and increased access to precision medicine as likely reasons why more women are surviving, even as diagnoses become more common.
There is no single explanation, but a range of lifestyle and environmental factors appear to play a role. Sedentary behavior, poor diets, obesity, exposure to pollutants and delayed childbirth have all been associated with a higher risk of breast cancer. Women today also tend to have fewer children and breastfeed less, both of which are protective factors.
Interestingly, highly educated women are at higher risk of developing breast cancer, likely due to a combination of factors such as postponing childbirth and higher levels of alcohol consumption. At the same time, these women are more likely to participate in regular screening programs and seek medical attention early. As a result, while their individual risk is higher, their chances of surviving the disease are better than those in lower socioeconomic groups.
This pattern highlights a recurring theme in cancer care: early detection and access to timely treatment make a major difference. But access is not distributed equally.
In the U.S., breast cancer mortality is lowest among women with private insurance. It increases for those covered by Medicare or Medicaid, and is highest for uninsured women. These differences are largely driven by when the cancer is diagnosed and how quickly treatment begins.
Race and ethnicity intersect with these factors. Black women in the U.S. not only face systemic barriers to care but are also more likely to develop aggressive forms of breast cancer, such as triple-negative tumors. These types do not respond to hormone therapy and are harder to treat. As a result, survival rates are lower even when treatment is available.
Disparities in the stage at which cancer is diagnosed also persist. Black women are 30% to 40% more likely to be diagnosed at a later stage than white women. And globally, the situation is even more concerning. In sub-Saharan Africa, around 75% of women with breast cancer are diagnosed at stage III or IV, when the disease is much harder to treat.
The World Health Organization warns that breast cancer deaths are expected to rise globally in the coming years, especially in low- and middle-income countries. While access to mammography, biopsies and modern treatments has become routine in wealthier nations, many women in low-resource settings still face long delays, limited treatment options and stigma around the disease.
This means that the encouraging decline in mortality seen in the U.S. and other high-income countries is not reflected worldwide. Instead, we are seeing a widening gap—where some women benefit from early detection and tailored treatment, while others continue to die from breast cancer that could have been detected earlier or treated more effectively.
Breast cancer is not just a medical condition—it is also a reflection of broader inequalities in health systems, infrastructure and access to information. Addressing these disparities will require political will, investment in primary care and education and a concerted effort to ensure that no woman dies from breast cancer simply because of where she lives or what she can afford.
The decline in mortality is a sign of progress. But it's also a reminder that progress is not shared equally—and that the fight against breast cancer is far from over.