美国出生于东非的黑人女性和其他黑人女性中的乳腺癌亚型。

Breast cancer subtypes among Eastern-African-born black women and other black women in the United States.

机构信息

Surveillance and Health Services Research, American Cancer Society, Atlanta, Georgia.

Department of Gynecology, Institute of Medical Epidemiology, Biometrics and Informatics, Martin-Luther University, Halle, Germany.

出版信息

Cancer. 2019 Oct 1;125(19):3401-3411. doi: 10.1002/cncr.32293. Epub 2019 Jun 13.

DOI:10.1002/cncr.32293

PMID:31190337

Abstract

BACKGROUND

A previous study reported that Eastern-African-born black women in the United States had lower prevalence of estrogen receptor-negative breast cancer than those in US-born and Western-African-born black women, among whom the prevalence was similar. It is unknown whether the prevalence of triple-negative breast cancer (negative for estrogen receptor, progesterone receptor, and human epidermal growth factor 2 receptor) among black women in the United States differs similarly by birthplace.

METHODS

In the National Program of Cancer Registries and US Cancer Statistics, the authors identified 65,211 non-Hispanic black women who were diagnosed with invasive breast cancer from 2010 through 2015 and were recorded as being born in the United States, East Africa, West Africa, or the Caribbean. The prevalence of triple-negative and hormone receptor-negative breast cancer (negative for estrogen receptor and progesterone receptor) among each group of foreign-born black women was compared with that among US-born black women and was expressed as the adjusted prevalence rate ratio, accounting for sociodemographic and tumor characteristics. Analyses were stratified by Census region, and region-specific estimates were summarized using random-effects meta-analyses.

RESULTS

Compared with US-born black women, the prevalence rate ratio of triple-negative breast cancer was 0.92 (95% CI, 0.81-1.04) among Western-African-born, 0.87 (95% CI, 0.78-0.98) among Caribbean-born, and 0.53 (95% CI, 0.37-0.77) among Eastern-African-born black women. Patterns for hormone receptor-negative tumors were generally similar, although the differences between populations were attenuated. The test for heterogeneity by Census region was not significant in any of the comparisons (all P for heterogeneity >.05).

CONCLUSIONS

The prevalence of triple-negative breast cancer among black women in the United States varied significantly by birthplace, particularly among Eastern-African-born black women. These findings underscore the importance of considering geographic origin in studies characterizing breast cancer among women of African descent in the United States and elsewhere.

摘要

背景

先前的一项研究报告称，与美国出生和西非出生的黑人女性相比，在美国出生的东非裔黑人女性患雌激素受体阴性乳腺癌的比例较低，而这两种人群的患病率相似。目前尚不清楚美国黑人女性中三阴性乳腺癌（雌激素受体、孕激素受体和人表皮生长因子 2 受体均为阴性）的患病率是否也因出生地不同而存在类似差异。

方法

作者在美国国家癌症登记处和美国癌症统计数据中，确定了 65211 名非西班牙裔黑人女性，这些女性在 2010 年至 2015 年间被诊断患有浸润性乳腺癌，且被记录为出生于美国、东非、西非或加勒比海。比较了每组外国出生的黑人女性中三阴性和激素受体阴性乳腺癌（雌激素受体和孕激素受体均为阴性）的患病率，并以调整后的患病率比表示，同时考虑了社会人口统计学和肿瘤特征。分析按人口普查区域进行分层，并使用随机效应荟萃分析总结各区域的估计值。

结果

与美国出生的黑人女性相比，西非出生的黑人女性中三阴性乳腺癌的患病率比为 0.92（95%CI，0.81-1.04），加勒比出生的为 0.87（95%CI，0.78-0.98），东非出生的为 0.53（95%CI，0.37-0.77）。激素受体阴性肿瘤的模式通常相似，尽管人群之间的差异有所减弱。在任何比较中，按人口普查区域进行的异质性检验均无统计学意义（所有 P 值均>0.05）。