Orange County and the San Francisco Bay Area continue leading the state in prevalence of breast cancer, and upper-income white women are most typically the victims, according to state officials.
From 1988 through 1990, women in Orange County and the Bay Area were diagnosed as having breast cancer at an average rate of 115 per 100,000 population, compared to a statewide average rate of 107, according to a report by the California Cancer Registry.
Disparities were pronounced among racial groups. In Orange County, breast cancers among white women were diagnosed at 127 per 100,000, compared to 53.9 for Hispanics and 48.7 for Asians and others.
"Breast cancer has been associated with upper income, a high-fat diet and late childbearing," said John Young, chief of the state's cancer surveillance section in Sacramento. "All those are probably characteristic of Orange County women who can afford to eat meat every day and put off childbearing while they are getting their careers started."
Hoda Anton-Culver, director of epidemiology for the UCI College of Medicine and director of Orange County's cancer surveillance program, said the incidence of breast cancer here has been exceptionally high since cancer data was first collected locally in 1984.
Although the diagnosis rate of new breast cancer cases in Orange County was higher than statewide, the death rate from breast cancer was only slightly greater--26.9 deaths per 100,000 people for Orange County compared to 26.7 deaths per 100,000 for the state during the 1988-1990 period studied by the California Cancer Registry.
"Either we are diagnosing it earlier or we have better and more aggressive treatment. I think it is a combination of both," said Anton-Culver.
"The higher-income women in Orange County who are more prone to get breast cancer also are likely to be diagnosed earlier and to be treated better because they have the financial means and are insured," she said.
Anton-Culver said UCI researchers are completing a study to discover if mammography has been effective in Orange County in increasing early diagnosis of breast cancer and survival rates.
She said it has already been determined that 80% of Orange County women over age 50 have had at least one mammogram. She said the rate is lower in less affluent areas of the nation.
According to the report, lung cancer remains the No. 1 killer in the state and the county.
In Orange County, lung cancer accounted for one out of every four cancer deaths between 1988 and 1990. A total of 10,658 Orange County residents died from all kinds of cancer in those three years, including 2,906 who died from lung cancer.
"Lung cancer has been increasing for a long time in women and continues to despite a reduction in smoking," Anton-Culver said. "But the disease is leveling off in men because they stopped smoking before women did."
While breast cancer was the most common cancer diagnosis for women in Orange County between 1988 and 1990, prostate cancer was the most common cancer diagnosis in men. In the three years, 2,715 Orange County men, or 104.8 per 100,000, were diagnosed with prostate cancer.
Prostate cancer was also the second-leading cause of death among Orange County men, accounting for 562 deaths from 1988 to 1990.
The American Cancer Society's Orange County unit is urging early screening for prostate cancer for men as well as breast cancer screening for women, said Margaret Edwards, the agency's director.
Edwards said the agency is completing a survey of Orange County residents who said they believe by far the greatest obstacles to seeking help for cancer are lack of insurance coverage, medical costs and the fear of discovering cancer.
"Unfortunately it is the fear associated with a cancer diagnosis that prevents people from regular cancer screenings," said Robert Merlino, a psychologist who specializes in working with the chronically ill, including cancer patients. "It delays diagnosis and puts people at greater risk from the disease."