Tuan Alyssa W, Davis Lynn Brittny C, Chernyavskiy Pavel, Yu Mandi, Gomez Scarlett L, Gierach Gretchen L, Rosenberg Philip S
Division of Cancer Control and Population Sciences, National Cancer Institute, National Institutes of Health, US Department of Health and Human Services, Bethesda, MD, USA.
Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, US Department of Health and Human Services, Bethesda, MD, USA.
JNCI Cancer Spectr. 2020 Feb 6;4(2):pkaa005. doi: 10.1093/jncics/pkaa005. eCollection 2020 Apr.
Westernization and etiologic heterogeneity may play a role in the rising breast cancer incidence in Asian American (AA) women. We report breast cancer incidence in Asian-origin populations.
Using a specialized Surveillance, Epidemiology, and End Results-9 Plus API Database (1990-2014), we analyzed breast cancer incidence overall, by estrogen receptor (ER) status, and age group among non-Hispanic white (NHW) and AA women. We used age-period-cohort models to assess time trends and quantify heterogeneity by ER status, race and ethnicity, and age.
Overall, breast cancer incidence increased for most AA ethnicities (Filipina: estimated annual percentage change [EAPC] = 0.96%/year, 95% confidence interval [CI] = 0.61% to 1.32%; South Asian: EAPC = 1.68%/year, 95% CI = 0.24% to 3.13%; Chinese: EAPC = 0.65%/year, 95% CI = 0.03% to 1.27%; Korean: EAPC = 2.55%/year, 95% CI = 0.13% to 5.02%; and Vietnamese women: EAPC = 0.88%/year, 95% CI = 0.37% to 1.38%); rates did not change for NHW (EAPC = -0.2%/year, 95% CI = -0.73% to 0.33%) or Japanese women (EAPC = 0.22%/year, 95% CI = -1.26% to 1.72%). For most AA ethnicities, ER-positive rates statistically significantly increased, whereas ER-negative rates statistically significantly decreased. Among older women, ER-positive rates were stable for NHW and Japanese women. ER-negative rates decreased fastest in NHW and Japanese women among both age groups.
Increasing ER-positive incidence is driving an increase overall for most AA women despite declining ER-negative incidence. The similar trends in NHW and Japanese women (vs other AA ethnic groups) highlight the need to better understand the influences of westernization and other etiologic factors on breast cancer incidence patterns in AA women. Heterogeneous trends among AA ethnicities underscore the importance of disaggregating AA data and studying how breast cancer differentially affects the growing populations of diverse AA ethnic groups.
西方化和病因异质性可能在亚裔美国（AA）女性乳腺癌发病率上升中起作用。我们报告了亚洲裔人群的乳腺癌发病率。
利用专门的监测、流行病学和最终结果-9加API数据库（1990 - 2014年），我们分析了非西班牙裔白人（NHW）和AA女性总体、按雌激素受体（ER）状态以及年龄组划分的乳腺癌发病率。我们使用年龄-时期-队列模型来评估时间趋势，并按ER状态、种族和民族以及年龄量化异质性。
总体而言，大多数AA族裔的乳腺癌发病率上升（菲律宾裔：估计年百分比变化[EAPC]=0.96%/年，95%置信区间[CI]=0.61%至1.32%；南亚裔：EAPC = 1.68%/年，95% CI = 0.24%至3.13%；华裔：EAPC = 0.65%/年，95% CI = 0.03%至1.27%；韩裔：EAPC = 2.55%/年，95% CI = 0.13%至5.02%；越南裔女性：EAPC = 0.88%/年，95% CI = 0.37%至1.38%）；NHW（EAPC = -0.2%/年，95% CI = -0.73%至0.33%）或日本女性（EAPC = 0.22%/年，95% CI = -1.26%至1.72%）的发病率没有变化。对于大多数AA族裔，ER阳性率在统计学上显著增加，而ER阴性率在统计学上显著下降。在老年女性中，NHW和日本女性的ER阳性率稳定。在两个年龄组中，NHW和日本女性的ER阴性率下降最快。
尽管ER阴性发病率下降，但ER阳性发病率的增加推动了大多数AA女性总体发病率的上升。NHW和日本女性（与其他AA族裔相比）的相似趋势凸显了更好地理解西方化和其他病因因素对AA女性乳腺癌发病模式影响的必要性。AA族裔之间的异质趋势强调了对AA数据进行分类并研究乳腺癌如何不同地影响不断增长的不同AA族裔人群的重要性。
