Kulkarni Aishwarya, Stroup Antoinette M, Paddock Lisa E, Hill Stephanie M, Plascak Jesse J, Llanos Adana A M
Department of Epidemiology, Rutgers School of Public Health, Piscataway, NJ, USA.
Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA.
Cancer Health Disparities. 2019;3:e1-e17. doi: 10.9777/chd.2019.1012. Epub 2019 Aug 19.
The objective of this study was to assess breast cancer incidence and mortality rates by molecular subtype for cases diagnosed in New Jersey. Data on all primary, histologically confirmed, invasive breast cancers diagnosed among women between January 1, 2008 and December 31, 2013 were retrieved from the New Jersey State Cancer Registry. Age-adjusted incidence rates were calculated for each subtype, by ageandrace/ethnicity. Logistic regression models, Cox proportional hazards models, and Kaplan Meier curves were used to describe the relative risks for breast cancer incidence, mortality, and survival, respectively. In this population-based sample of 32,770 breast cancer cases, non-Hispanic Blacks (NHBs) had the highest triple-negative breast cancer (TNBC) incidence rate (17.8 per 100,000, 95% CI 16.5-19.2) compared to other races/ethnicities. NHBs had also higher odds of TNBC (OR 2.1, 95% CI 1.95-2.36) and higher hazards of death when diagnosed with TNBC (HR 1.28, 95% CI 1.05-1.56), luminal A (HR 1.64, 95% CI 1.41-1.91), or luminal B (HR 1.54, 95% CI 1.10-2.15) than non-Hispanic Whites (NHWs). Younger women (20-39 years) had higher odds of TNBC (OR 1.77, 95% CI 1.54-2.02) and luminal B (OR 1.56, 95% CI 1.35-1.80) compared to women 50-64 years; minority women had higher odds of non-luminal HER2-expressing and lower odds of luminal A than NHWs. TNBC was associated with the poorest survival rates. These findings highlight a need for enhanced screening to promote earlier diagnosis and improve breast cancer outcomes, particularly in minorities and younger women, which will be essential for achieving health equity.
本研究的目的是评估新泽西州确诊病例按分子亚型划分的乳腺癌发病率和死亡率。从新泽西州癌症登记处检索了2008年1月1日至2013年12月31日期间诊断出的所有原发性、经组织学确诊的浸润性乳腺癌女性患者的数据。按年龄和种族/族裔计算了各亚型的年龄调整发病率。分别使用逻辑回归模型、Cox比例风险模型和Kaplan-Meier曲线来描述乳腺癌发病率、死亡率和生存率的相对风险。在这个基于人群的32770例乳腺癌病例样本中，与其他种族/族裔相比，非西班牙裔黑人（NHB）的三阴性乳腺癌（TNBC）发病率最高（每10万人中有17.8例，95%置信区间16.5-19.2）。NHB患TNBC的几率也更高（优势比2.1，95%置信区间1.95-2.36），并且在诊断为TNBC、腔面A型（风险比1.64，95%置信区间1.41-1.91）或腔面B型（风险比1.54，95%置信区间1.10-2.15）时，死亡风险高于非西班牙裔白人（NHW）。与50-64岁的女性相比，年轻女性（20-39岁）患TNBC（优势比1.77，95%置信区间1.54-2.02）和腔面B型（优势比1.56，95%置信区间1.35-1.80）的几率更高；少数族裔女性患非腔面HER2表达型乳腺癌的几率高于NHW，而患腔面A型乳腺癌的几率低于NHW。TNBC与最差的生存率相关。这些发现凸显了加强筛查以促进早期诊断和改善乳腺癌治疗效果的必要性，特别是在少数族裔和年轻女性中，这对于实现健康公平至关重要。
