Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins School of Medicine, Baltimore, Maryland.
Cancer. 2022 Mar 1;128(5):1015-1023. doi: 10.1002/cncr.34008. Epub 2021 Nov 3.
The incidence rate of breast cancer has been increasing over time across race/ethnicity in the United States. It is unclear whether these trends differ among stage, poverty, and geography subgroups.
Using data from the North American Association of Central Cancer Registries, this study estimated trends in age-adjusted breast cancer incidence rates among women aged 50 to 84 years from 1999 to 2017 by race/ethnicity (non-Hispanic Black, non-Hispanic White, and Hispanic) and across subgroups (stage, county-level poverty, county urban/rural status, and geographic region [West, Midwest, South, and Northeast]).
From 2004 to 2017, breast cancer incidence rates increased across race/ethnicity and subgroups, with the greatest average annual percent increases observed for non-Hispanic Black women, overall (0.9%) and those living in lower poverty areas (0.8%), rural areas (1.2%), and all regions except the West (0.8%-1.0%). Stronger increases among non-Hispanic Black women were observed for local-stage disease and for some subgroups of distant-stage disease. Non-Hispanic Black women had the smallest decrease in regional-stage disease across most subgroups. Similarly, Hispanic women had the strongest increases in some subgroups, including areas with higher poverty (0.6%-1.2%) and in the West (0.8%), for local- and distant-stage disease.
These trends highlight concerns for an increasing burden of breast cancer among subpopulations, with some already experiencing disparate breast cancer mortality rates, and they highlight the need for targeted breast cancer prevention and efforts to reduce mortality disparities in areas with increasing incidence.
在美国,不同种族/族裔的乳腺癌发病率随时间推移呈上升趋势。目前尚不清楚这些趋势是否在不同分期、贫困程度和地理亚组之间存在差异。
本研究利用北美癌症监测协会中央癌症登记处的数据,估计了 1999 年至 2017 年间年龄调整后 50 至 84 岁女性乳腺癌发病率在非西班牙裔黑人、非西班牙裔白人和西班牙裔人群中的种族/族裔(非西班牙裔黑人、非西班牙裔白人和西班牙裔)和亚组(分期、县贫困程度、县城乡/农村状况和地理区域[西部、中西部、南部和东北部])的变化趋势。
2004 年至 2017 年间,乳腺癌发病率在不同种族/族裔和亚组中均呈上升趋势,非西班牙裔黑人女性的平均年增长率最高(整体为 0.9%,生活在贫困程度较低地区的女性为 0.8%,农村地区为 1.2%,除西部以外的所有地区为 0.8%-1.0%)。非西班牙裔黑人女性的局部疾病和某些远处疾病的亚组中观察到更强的增长率。在大多数亚组中,非西班牙裔黑人女性的区域性疾病呈最小幅度下降。同样,在某些亚组中,包括贫困程度较高的地区(0.6%-1.2%)和西部(0.8%),西班牙裔女性的增长率最高,包括局部和远处疾病。
这些趋势凸显了某些亚人群乳腺癌负担不断增加的问题,其中一些人群已经面临乳腺癌死亡率的差异,这突显了在发病率不断上升的地区需要有针对性地开展乳腺癌预防和努力减少死亡率差异。