Moores USCD Cancer Center, USCD School of Medicine, University of California at San Diego, La Jolla, California, USA.
J Womens Health (Larchmt). 2010 Feb;19(2):203-7. doi: 10.1089/jwh.2008.1314.
This study analyzed early breast cancer detection rates as a surrogate for breast cancer mortality rates. Stage at diagnosis was broken down by race/ethnicity and year of diagnosis for the cases of female breast cancer in the California Cancer Registry from 1988 to 2002.
A quarter million cases of breast cancer in women > or =50 years of age recorded in the California Cancer Registry over the period 1988-2002 were classified as early (in situ and localized stages) or late (regional and distant stages). The increases in the percent of cases that were early were studied by 3-year periods over this interval. In addition to the total group, data were broken down by race/ethnicity. The 3-year periods were used to compensate for small numbers of cases in some of the nonwhite groups.
The proportion of early stage female breast cancers reached a plateau at 70% in the mid-1990s. African American and Hispanic women's screening rates reached a plateau at a considerably lower rate. Only Pacific Islander/Asian American women demonstrated a sustained rise in the percent of early breast cancers detected through 2002, eventually nearing the rate of early detection set by white women.
The plateaus observed suggest that focused interventions continue to be needed for all women, especially for African American and Hispanic women if the American Cancer Society's 2015 goals are to be achieved.
本研究以早期乳腺癌检出率作为乳腺癌死亡率的替代指标进行分析。通过对 1988 年至 2002 年加利福尼亚癌症登记处女性乳腺癌病例的种族/族裔和诊断年份进行分层,分析诊断时的分期。
对 1988-2002 年期间加利福尼亚癌症登记处记录的 25 万例 50 岁以上女性乳腺癌病例进行分类,分为早期(原位和局限性阶段)或晚期(区域性和远处转移阶段)。通过 3 年间隔期研究这一期间早期病例百分比的增加情况。除了总组数据外,还按种族/族裔进行了细分。使用 3 年间隔期是为了弥补某些非白人组病例数量较少的问题。
在 20 世纪 90 年代中期,早期女性乳腺癌的比例达到了 70%的平台期。非裔美国人和西班牙裔女性的筛查率达到了一个相当低的平台期。只有太平洋岛民/亚裔美国女性在 2002 年之前持续增加了早期乳腺癌的检出率,最终接近白人女性设定的早期检出率。
观察到的平台期表明,所有女性都需要持续进行有针对性的干预,特别是对于非裔美国人和西班牙裔女性,如果要实现美国癌症协会 2015 年的目标的话。