Department of Society, Human Development and Health, Harvard School of Public Health, Kresge 717, 677 Huntington Ave, Boston, MA 02115, USA.
Am J Public Health. 2010 Apr 1;100 Suppl 1(Suppl 1):S132-9. doi: 10.2105/AJPH.2009.181628. Epub 2010 Feb 10.
We investigated whether there were socioeconomic and racial/ethnic disparities in recent reported declines in overall US breast cancer incidence rates attributed to post-2002 declines in hormone therapy use following publication of the Women's Health Initiative study.
We analyzed 1992-2005 US breast cancer incidence data from the US Surveillance, Epidemiology and End Result (SEER) 13 Registries Database, stratified by race/ethnicity, county income level, age, and estrogen receptor (ER) status.
As we hypothesized, between 1992 and 2005, the temporal pattern of rising and then falling US breast cancer incidence rates occurred only among White non-Hispanic women who lived in high-income counties, were aged 50 years and older, and had ER-positive tumors. No such trends were evident--regardless of county income level, ER status, or age--among Black non-Hispanic, Asian/Pacific Islander, Hispanic, or-where numbers were sufficient to conduct meaningful analyses-American Indian/Alaska Native women.
The recent decline in US breast cancer incidence was not equally beneficial to all women, but instead mirrored the social patterning of hormone therapy use. Joint information on socioeconomic resources and race/ethnicity is vital for correctly understanding disease distribution, including that of breast cancer.
我们调查了在妇女健康倡议研究发表后，由于激素疗法使用的减少，最近美国整体乳腺癌发病率的下降是否存在社会经济和种族/民族差异。
我们分析了美国监测、流行病学和最终结果（SEER）13 个登记处数据库中 1992-2005 年的美国乳腺癌发病率数据，按种族/民族、县收入水平、年龄和雌激素受体（ER）状态进行分层。
正如我们假设的那样，在 1992 年至 2005 年间，美国乳腺癌发病率上升然后下降的时间模式仅发生在居住在高收入县、年龄在 50 岁及以上且患有 ER 阳性肿瘤的白人非西班牙裔女性中。在黑人非西班牙裔、亚洲/太平洋岛民、西班牙裔或在数量足以进行有意义的分析的美国印第安人/阿拉斯加原住民女性中，无论县收入水平、ER 状态或年龄如何，都没有出现这种趋势。
最近美国乳腺癌发病率的下降并非对所有女性都同样有益，而是反映了激素疗法使用的社会模式。关于社会经济资源和种族/民族的综合信息对于正确理解疾病分布至关重要，包括乳腺癌的分布。
