The Impact of an Aging America

The recently released, Annual Report to the Nation on the Status of Cancer, 1973-1998, published in the June 6, 2001 issue of the Journal of the National Cancer Institute, reports that breast cancer death rates have continued to decline in the United States, possibly due to improvements in early detection and treatment. However, breast cancer incidence rates have increased by more than 40 percent from 1973 to 1998. The report suggests that the use of aggressive screening and early detection, primarily mammography, may lead to more early stage diagnoses, and as a result, higher incidence figures.

Commenting on the report, Susan Braun, president and CEO of the Susan G. Komen Breast Cancer Foundation, Dallas, noted that the nation is likely to see even greater increases in incidence rates in the coming years as the population ages. "The two most common breast cancer risk factors are being a woman and growing older," Braun said. "Therefore, as baby boomers age, more cases of breast cancer are going to be reported each year."

There are more women alive today in every five-year age group from age 40 to age 64.

What do population trends mean in terms of breast cancer incidence? We know that the older women are, the greater their risk for breast cancer. According to the American Cancer Society's Fast Facts, women under the age of 40 account for only 5 percent of breast cancer cases. More than 75 percent of women who are diagnosed with breast cancer are age 50 or older.

We continually hear about the aging Baby Boom generation. This is clearly seen if we compare 2000 census estimates of the female population to 1995 estimates. There are more women alive today in every five-year age group from age 40 to age 64. This shift in population means that there is a larger group of women who are at greater risk for breast cancer simply because of their age.

How will this trend impact my business?

An increase in breast cancer diagnoses means an increase in the number of surgeries in your community, whether they are mastectomies or breast conserving surgeries. Some communities could experience larger numbers if they are a retirement destination. Simply stated, more women will require post-surgical products and services, even when re-construction is selected.

What about increases in reconstructive surgeries?

Reconstruction following mastectomy has been on the rise, most likely boosted by passage of the Women's Health and Cancer Rights Act of 1998. From 1992 to 1999, the number of reconstructions performed annually rose from 29,607 to 82,975. While reconstruction can be performed at the time of the mastectomy, it is scheduled for a later date. There are a number of reasons reconstruction may be delayed, but these can include:

Chemotherapy and Radiation

Reconstruction often can be done immediately when a woman has early stage breast cancer. But women who have an intermediate or advanced stage will typically undergo chemotherapy and/or radiation. Reconstruction is delayed anywhere from six months to a year until treatment is completed.


A woman may live quite a distance away from a cancer center or may wish to have her surgery done by a surgeon in another community. When this is the case, she may delay her surgery until she can make these arrangements.


Women are busy with families and careers. Reconstruction requires several weeks of recovery--activity and lifting restrictions--as well as frequent follow-up visits. There may be additional minor surgeries in order to obtain the patient's desired result. It can be a challenge finding the best time to fit reconstructive surgery into a busy life.


For any number of reasons, a woman may not be ready to have reconstruction immediately. Emotionally, she may not be ready to have another surgery right away. Or perhaps she would like to do her own research. Whatever her personal reasons, she may wait months or years before having surgery.

When reconstruction is not done at the time of the mastectomy, a woman needs a prosthesis for the intervening time. If reconstruction numbers continue to rise, this could become a significant part of your business.

As baby boomers age, more cases of breast cancer are going to be reported each year.

What other trends should be examined?

Learn about the demographics of your community as well as the surgical practices in your community. An early-stage diagnosis can mean breast-conserving surgery. However, a young woman with an early-stage diagnosis may choose a mastectomy since statistically, her chance of a recurrence may be greater than an older woman's.

What can you conclude?

Many facts and trends should be evaluated when making your business plans for the short and long-term. Surgery trends may initially indicate a smaller market for post-surgical prostheses and bras. This trend may be at least partially offset by a combination of an increase in the incidence of breast cancer and the need for interim products while awaiting reconstruction. Women who have had breast-conserving surgery may still require a partial form. Find out what is occurring in your community and plan accordingly.

This article originally appeared in the September 2001 issue of HME Business.

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