From the Department of Population Health Sciences and Carbone Cancer Center, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI.
Department of Radiation Oncology, Ann Arbor, MI.
Epidemiology. 2021 Nov 1;32(6):904-913. doi: 10.1097/EDE.0000000000001394.
Recent reports suggest that racial differences in breast cancer incidence rates have decreased. We examined whether these findings apply to breast cancer mortality while considering age, period, and cohort influences on both absolute and relative measures of breast cancer mortality.
Using publicly available datasets (CDC WONDER, Human Mortality Database), we developed an age-period-cohort model of breast cancer mortality and breast cancer deaths as a proportion of all deaths during 1968-2019 among all women and by 5 race/ethnicity groups with sufficient numbers for estimation: Hispanic (all races), American Indian/Alaska Native and Asian/Pacific Islanders (regardless of ethnicity), non-Hispanic Black, and non-Hispanic White.
Initially increasing after 1968, age-adjusted breast cancer mortality rates have decreased among all racial/ethnic groups since 1988. The age-adjusted percent of all deaths due to breast cancer also has been declining for non-Hispanic White women since about 1990 while increasing or holding steady for other race/ethnic groups. In 2019, the age-adjusted percent of deaths due to breast cancer for women was highest for Asian/Pacific Islanders (5.6%) followed by non-Hispanic Black (4.5%), Hispanic (4.4%), non-Hispanic White (4.1%), and American Indian/Alaska Native women (2.6%).
Breast cancer mortality disparities are now greater on both relative and absolute scales for non-Hispanic Black women, and using the relative scale for Asian/Pacific Islander and Hispanic women, compared with non-Hispanic White women for the first time in 50 years.
最近的报告表明,乳腺癌发病率的种族差异已经缩小。我们研究了在考虑年龄、时期和队列对乳腺癌死亡率的绝对和相对指标的影响的同时,这些发现是否适用于乳腺癌死亡率。
我们使用公开可用的数据集(CDC WONDER、人类死亡率数据库),为乳腺癌死亡率和乳腺癌死亡人数(占所有死亡人数的比例)开发了一个年龄-时期-队列模型,这些数据涵盖了 1968 年至 2019 年期间所有女性,以及足够数量可供估计的 5 个种族/族裔群体:西班牙裔(所有种族)、美洲印第安人/阿拉斯加原住民和亚洲/太平洋岛民(无论种族如何)、非西班牙裔黑人以及非西班牙裔白人。
自 1988 年以来,所有种族/族裔群体的年龄调整乳腺癌死亡率自 1968 年以来最初呈上升趋势后一直在下降。自 1990 年以来,非西班牙裔白人女性死于乳腺癌的比例一直在下降,而其他种族/族裔群体的比例则在增加或保持稳定。2019 年,死于乳腺癌的女性比例最高的是亚洲/太平洋岛民(5.6%),其次是非西班牙裔黑人(4.5%)、西班牙裔(4.4%)、非西班牙裔白人(4.1%)和美洲印第安人/阿拉斯加原住民妇女(2.6%)。
与非西班牙裔白人女性相比,非西班牙裔黑人女性的乳腺癌死亡率的相对和绝对差异现在更大,而对于亚洲/太平洋岛民和西班牙裔女性来说,这是 50 年来首次使用相对比例。