Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD.
J Natl Cancer Inst. 2018 Nov 1;110(11):1270-1272. doi: 10.1093/jnci/djy112.
Recent reports of converging black and white breast cancer incidence rates have gained much attention, potentially foreshadowing a worsening of the black-white breast cancer mortality disparity. However, these incidence rates also reflect the sum of non-Hispanics and Hispanics that may mask important ethnicity-specific trends. We therefore assessed race- and ethnicity-specific breast cancer trends using the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) 13 Registries Database (1992-2014). Age-period-cohort models projected rates for 2015-2030. Results confirmed merging of age-standardized incidence rates for blacks and whites circa 2012, but not for non-Hispanic black (NHB) and non-Hispanic white (NHW) women. Incidence rates were highest for NHW women (n = 382 290), followed by NHB women (n = 51 074), and then Hispanic white women (n = 48 651). The sample size for Hispanic blacks was too small for analysis (n = 693). Notably, future incidence rates are expected to slowly increase (2015 through 2030) among NHW women (0.24% per year, 95% confidence interval [CI] = 0.17 to 0.32) and slowly decrease for NHB women (-0.14% per year, 95% CI = -0.15 to -0.13). A putative worsening of the black-white mortality disparity, therefore, seems unlikely. Ethnicity matters when assessing race-specific breast cancer incidence rates.
最近关于黑人和白人乳腺癌发病率趋同的报告引起了广泛关注,这可能预示着黑人和白人乳腺癌死亡率差距的恶化。然而,这些发病率也反映了非西班牙裔和西班牙裔的总和,这可能掩盖了重要的种族特异性趋势。因此,我们使用美国国家癌症研究所的监测、流行病学和最终结果(SEER)13 个登记数据库(1992-2014 年)评估了种族和族裔特异性的乳腺癌趋势。年龄-时期-队列模型预测了 2015-2030 年的发病率。结果证实,大约在 2012 年,黑人的年龄标准化发病率与白人趋同,但非西班牙裔黑人(NHB)和非西班牙裔白人(NHW)妇女的发病率没有趋同。发病率最高的是 NHW 妇女(n=382290),其次是 NHB 妇女(n=51074),然后是西班牙裔白人妇女(n=48651)。由于样本量太小,无法对西班牙裔黑人进行分析(n=693)。值得注意的是,未来的发病率预计将在 NHW 妇女中缓慢增加(2015 年至 2030 年)(每年 0.24%,95%置信区间[CI]为 0.17 至 0.32),而 NHB 妇女的发病率将缓慢下降(每年-0.14%,95%CI=-0.15 至-0.13)。因此,黑人-白人死亡率差距的恶化似乎不太可能。在评估种族特异性乳腺癌发病率时,种族是很重要的。