Associations of Obesity, Physical Activity, and Screening With State-Level Trends and Racial and Ethnic Disparities of Breast Cancer Incidence and Mortality in the US.

27 American Indian or Alaska Native, Asian or Pacific Islander, and Black women showed a rising trend, with a significant trend among American Indian or Alaska Native women throughout the period 1999 to 2017.

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Twelve states showed an increasing trend, of which 2 (Mississippi and Tennessee) were significant, whereas 33 states and the District of Columbia showed a decreasing trend, with 14 being significant; there was no trend change in the remaining 5 states (eTable 1 in the Supplement ).

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