From the U.S. Government Accountability Office, www.gao.gov

Transcript for: Breast Cancer Education

Description: Audio interview by GAO staff with Marcia Crosse, Director,
Health Care

Related GAO Work: GAO-17-19: Breast Cancer Education: HHS Has
Implemented Initiatives Aimed at Young Women
Released: October 2016


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[ Narrator: ] Welcome to GAO's Watchdog Report, your source for news and
information from the U.S. Government Accountability Office. It's October
2016. Breast cancer is often thought of as an older women's disease, but
it also affects women under 45. Researchers have found that younger
women with breast cancer tend to be diagnosed at a later stage,
experience worse outcomes and face unique issues in their treatment such
as worrying about how it will affect their fertility. A team led by
Marcia Crosse, a director on GAO's Health Care team, recently looked at
the federal government's efforts to provide or support breast cancer
education for young women. Jacques Arsenault sat down with Marcia to
talk about what they found.

[ Jacques Arsenault: ] Breast cancer most commonly affects older women,
but can you talk about the effects that it can have on younger women?

[ Marcia Crosse: ] Yes. It's true. Breast cancer is mostly a disease of
older women. About a quarter of a million women will be diagnosed with
breast cancer every year, and about 11 percent of those are young women,
and by young women, we mean women under age 45. So that means that there
are about 27,000 cases a year in the United States of young women who
develop breast cancer, and they have some particular challenges. For
younger women, there may be concerns about caring for a young family.
They may be concerned about their fertility. They may not have completed
their family. They may also be more concerned than older women about
their body image or about impacts of the cancer on their professional
lives and so they have different concerns than older women may have.

[ Jacques Arsenault: ] So then, what's the federal government's role in
building awareness?

[ Marcia Crosse: ] Well, in 2009, the government passed a law called the
EARLY Act that required some additional focus on young women because of
these special challenges that they have, and so the Centers for Disease
Control and other components of the Department of Health and Human
Services have been funding some additional research on prevention that's
targeted specifically at the kinds of breast cancer that affects younger
women. They've also been funding a public education campaign to try to
put out more information that targets this group, and they funded some
support grants for these women, and they're trying to educate health
professionals about the special challenges and about being more aware
that breast cancer can occur in young women.

[ Jacques Arsenault: ] So it sounds like there's a combination of
research and different programs to build awareness not only among young
women but among the people that work with them, the healthcare
professionals. Are there specific behaviors or steps that these programs
are encouraging young women to do?

[ Marcia Crosse: ] Yes. Well, they're specifically encouraging young
women to know their risks. They should be talking to their family
members to find out if there's any family history of breast cancer,
particularly breast cancer among younger members. They may want to have
some screening if they're in a particular ethnic group. They may want to
be screened for what's called the BRCA gene, the B-R-C-A gene, which can
significantly increase the likelihood that they could develop breast
cancer at an early age. And so they're trying to get information out so
that young women can take advantage of the resources that are available
to understand their risks and to be screened and diagnosed early if
they're at high risk.

[ Jacques Arsenault: ] Let me ask you then. With the range of programs
that Health and Human Services is putting out around this, do they seem
to be effective from what your team has seen?

[ Marcia Crosse: ] Well, it's really too early. This has only been going
on for a few years, so it's too soon to know if they're effective. But
they do seem to be targeting the areas that are of particular concern,
and they're not duplicating the other kinds of efforts that are there
for breast cancer. They're supplementing those programs with a
particular emphasis on the younger women.

[ Jacques Arsenault: ] So then finally, what would you say is the bottom
line of this report?

[ Marcia Crosse: ] I think the bottom line of this report is that young
women should be taking advantage of the kind of resources that are being
made available to them to understand their own risks and to take
advantage of the information and support that's out there if they are at
higher risk of developing breast cancer at a young age.

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