Hennis Anselm J, Hambleton Ian R, Wu Suh-Yuh, Leske Maria Cristina, Nemesure Barbara
Chronic Disease Research Centre, The University of the West Indies, Bridgetown, Barbados, West Indies.
Int J Cancer. 2009 Jan 15;124(2):429-33. doi: 10.1002/ijc.23889.
We describe breast cancer incidence and mortality in the predominantly African-origin population of Barbados, which shares an ancestral origin with African-Americans. Age-standardized incidence rates were calculated from histologically confirmed breast cancer cases identified during a 45-month period (July 2002-March 2006). Mortality rates were estimated from death registrations over 10-years starting January 1995. There were 396 incident cases of breast cancer for an incidence rate of 78.1 (95% confidence interval (CI) 70.5-86.3), standardized to the US population. Breast cancer incidence in African-Americans between 2000 and 2004 was 143.7 (142.0-145.5) per 100,000. Incidence peaked at 226.6 (174.5-289.4) per 100,000 among Barbadian women aged 50-54 years, and declined thereafter, a pattern in marked contrast to trends in African-American women, whose rates continued to increase to a peak of 483.5 per 100,000 in those aged 75-79 years. Incidence rate ratios comparing Barbadian and African-American women showed no statistically significant differences among women aged>or=55 years (p<or=0.001 at all older ages). The age-standardized mortality rate in Barbados was 32.9 (29.9-36.0) per 100,000; similar to reported US rates. The pattern of diverging breast cancer incidence between Barbadian and African-American women may suggest a greater contribution from genetic factors in younger women, and from environmental factors in older women. Studies in intermediate risk populations, such as Barbados, may assist the understanding of racial disparities in breast cancer.
我们描述了巴巴多斯以非洲裔为主的人群中的乳腺癌发病率和死亡率，该人群与非裔美国人有着共同的祖先。年龄标准化发病率是根据在45个月期间（2002年7月至2006年3月）确诊的组织学乳腺癌病例计算得出的。死亡率是根据1995年1月开始的10年死亡登记估算的。共有396例乳腺癌发病病例，发病率为78.1（95%置信区间（CI）70.5 - 86.3），以美国人群为标准进行标准化。2000年至2004年期间，非裔美国人的乳腺癌发病率为每10万人143.7（142.0 - 145.5）例。巴巴多斯50 - 54岁女性的发病率最高，为每10万人226.6（174.5 - 289.4）例，此后下降，这一模式与非裔美国女性的趋势形成鲜明对比，非裔美国女性的发病率持续上升，在75 - 79岁人群中达到每10万人483.5例的峰值。比较巴巴多斯和非裔美国女性的发病率比在年龄≥55岁的女性中没有显示出统计学上的显著差异（所有老年年龄组p≤0.001）。巴巴多斯的年龄标准化死亡率为每10万人32.9（29.9 - 36.0）例；与美国报告的比率相似。巴巴多斯和非裔美国女性之间乳腺癌发病率的差异模式可能表明，年轻女性中遗传因素的贡献更大，而老年女性中环境因素的贡献更大。对巴巴多斯等中等风险人群的研究可能有助于理解乳腺癌的种族差异。
