Heart disease

Heart disease is the number one killer of American women [1]. Although it is typically viewed as a man's disease, more women actually die of heart disease each year than men. On average, women develop heart disease later in life than do men, and women are more likely then men to have other co-existing, chronic conditions that may mask their heart disease symptoms. Heart attack symptoms in women may also differ from those in men, leading to misdiagnosis [11]. Women who recover from a heart attack are more likely than men to have a stroke or to have another heart attack [12]. In fact, 42 percent of women die within a year following a heart attack compared to 24 percent of men [13].

Cancer

Cancer is the second leading killer of American women [14]. Since 1987, lung cancer has been the leading cause of cancer death among women in the United States, with an estimated 66,000 deaths in 1999 [14]. Over the past 10 years, the mortality rate from lung cancer has declined in men but has continued to rise in women [14]. These alarming trends are under-recognized by women and due almost exclusively to increased rates of cigarette smoking in women. At present, breast cancer is the second leading cancer killer of American women, claiming the lives of 43,300 women in 1999 [14]. The incidence of breast cancer rose steadily from 1940 to 1990, then stabilized at approximately 110 cases per 100,000 women [14]. With the increased use of mammography screening, breast cancers have increasingly been detected earlier in their development, when they are more treatable. This earlier detection, coupled with improved treatment has led to a decline in breast cancer death rates. Between 1990 and 1994, breast cancer mortality decreased by 5.6 percent. This decline was more pronounced among white women (-6.1 percent) than among African American women (-1 percent)1. Colorectal cancer accounts for the third leading cause of cancer deaths in American women [14]. Although many cases are preventable with regular screening, regular exercise, and a diet low in fat and high in fruits, vegetables, and whole-grain foods, colorectal cancer is expected to claim the lives of 28,800 women in 1999 [14]. With the advent of the Pap smear, the early detection and prevention of cervical cancer has improved dramatically. Both the incidence and death rates from this disease have declined by 40 percent since the early 1970s [15]. However, many elderly, low-income, and rural women remain at high risk for this disease, because they are not obtaining regular Pap screenings. Other major risk factors include cigarette smoking and infection with certain types of the human papillomavirus (HPV)15. An estimated 12,800 new cases of cervical cancer are expected to be diagnosed in 1999, and an estimated 4,800 deaths14. The Pap smear and pelvic examination are only partially successful at detecting endometrial (uterine lining) cancer, which claimed an estimated 37,400 new cases in 1999, and led to 6,400 deaths [14]. Although the incidence of ovarian cancer is lower, ovarian cancer is the most deadly of all the cancers of the female reproductive system. Symptoms often appear only in the very advanced stages of the disease. In 1999, there were nearly 25,200 ovarian cancer cases with over 14,500 deaths [14]. Melanoma-the most serious form of skin cancer-is the most frequent cancer in women 25 to 29 years of age and the second most frequent (after breast cancer) in women ages 30 to 34. Although overall, men are more likely than women to develop skin cancer, women under the age of 40 comprise the fastest growing group of skin cancer patients and the rate of new melanoma cases is increasing. Since 1973, it has doubled from 6 cases per 100,000 people to 13 per 100,000 in 1995 [16].