Deloumeaux J, Gaumond S, Bhakkan B, Manip M'Ebobisse Nsome, Lafrance W, Lancelot Pierre, Vacque D, Negesse Y, Diedhiou A, Kadhel P
Registre général des Cancers de Guadeloupe, Centre Hospitalier Universitaire de Guadeloupe, Guadeloupe.
Service d'anatomopathologie, Centre Hospitalier Universitaire de Guadeloupe, Guadeloupe.
Cancer Epidemiol. 2017 Apr;47:42-47. doi: 10.1016/j.canep.2017.01.004. Epub 2017 Jan 21.
Geographical disparities in breast cancer incidence and outcomes are reported worldwide. Women of African descent show lower incidence, higher mortality rates and earlier age of onset. We analyzed data from the cancer registry of Guadeloupe for the period 2008-2013.
We describe breast cancer characteristics by molecular subtype, as well as estimated observed and net survival. We used Cox proportional hazard models to determine associations between cancer subtypes and death rate, adjusted for variables of interest.
Overall, 1275 cases were recorded with a mean age at diagnosis of 57(±14) years. World standardized incidence and mortality were respectively 71.9/100,000 and 14.1/100,000 person-years. Age-specific incidence rates were comparable to European and US populations below the age of 45, and higher in Guadeloupean women aged between 45 and 55 years. Overall, 65.1% of patients were hormone receptor (HR)+ and 20.1% were HR-. Triple negative breast cancers (TNBC) accounted for 14% of all cases, and were more frequent in patients under 40 (21.6% vs. 13.4%, p=0.02). Five-year net survival was 84.9% [81.4-88.6]. It was higher for HR+/Her2+ and HR+/Her2- subtypes, and lower for HR-/Her2+ and TNBC patients.
We found high age-specific incidence rates of breast cancer in women aged 45 to 55 years, which warrants further investigation in our population. However, this population of mainly African descent had good overall survival rates, and data according to subtypes are consistent with those reported internationally. These results may suggest that poorer survival in other African descent populations may not be an inherent feature of the disease but may be amenable to improvement.
全球范围内均有关于乳腺癌发病率和治疗结果存在地域差异的报道。非洲裔女性的乳腺癌发病率较低、死亡率较高且发病年龄较早。我们分析了瓜德罗普岛癌症登记处2008年至2013年期间的数据。
我们按分子亚型描述乳腺癌特征，并估计观察到的生存率和净生存率。我们使用Cox比例风险模型来确定癌症亚型与死亡率之间的关联，并对感兴趣的变量进行了调整。
总体而言，共记录了1275例病例，诊断时的平均年龄为57（±14）岁。世界标准化发病率和死亡率分别为每10万人年71.9例和14.1例。45岁以下人群的年龄别发病率与欧洲和美国人群相当，而瓜德罗普岛45至55岁女性的发病率更高。总体而言，65.1%的患者为激素受体（HR）阳性，20.1%为HR阴性。三阴性乳腺癌（TNBC）占所有病例的14%，在40岁以下患者中更为常见（21.6%对13.4%，p=0.02）。五年净生存率为84.9%[81.4 - 88.6]。HR+/Her2+和HR+/Her2-亚型的生存率较高，而HR-/Her2+和TNBC患者的生存率较低。
我们发现45至55岁女性的乳腺癌年龄别发病率较高，这值得在我们的人群中进一步研究。然而，这个主要为非洲裔的人群总体生存率良好，按亚型划分的数据与国际上报道的数据一致。这些结果可能表明，其他非洲裔人群较差的生存率可能不是该疾病的固有特征，而是可以改善的。
