Surveillance & Health Equity Science, American Cancer Society, Atlanta, Georgia, USA.
Department of Surgery, New York-Presbyterian, Weill Cornell Medicine, New York, New York, USA.
CA Cancer J Clin. 2024 Nov-Dec;74(6):477-495. doi: 10.3322/caac.21863. Epub 2024 Oct 1.
This is the American Cancer Society's biennial update of statistics on breast cancer among women based on high-quality incidence and mortality data from the National Cancer Institute and the Centers for Disease Control and Prevention. Breast cancer incidence continued an upward trend, rising by 1% annually during 2012-2021, largely confined to localized-stage and hormone receptor-positive disease. A steeper increase in women younger than 50 years (1.4% annually) versus 50 years and older (0.7%) overall was only significant among White women. Asian American/Pacific Islander women had the fastest increase in both age groups (2.7% and 2.5% per year, respectively); consequently, young Asian American/Pacific Islander women had the second lowest rate in 2000 (57.4 per 100,000) but the highest rate in 2021 (86.3 per 100,000) alongside White women (86.4 per 100,000), surpassing Black women (81.5 per 100,000). In contrast, the overall breast cancer death rate continuously declined during 1989-2022 by 44% overall, translating to 517,900 fewer breast cancer deaths during this time. However, not all women have experienced this progress; mortality remained unchanged since 1990 in American Indian/Alaska Native women, and Black women have 38% higher mortality than White women despite 5% lower incidence. Although the Black-White disparity partly reflects more triple-negative cancers, Black women have the lowest survival for every breast cancer subtype and stage except localized disease, with which they are 10% less likely to be diagnosed than White women (58% vs. 68%), highlighting disadvantages in social determinants of health. Progress against breast cancer could be accelerated by mitigating racial, ethnic, and social disparities through improved clinical trial representation and access to high-quality screening and treatment.
这是美国癌症协会基于美国国家癌症研究所和疾病控制与预防中心的高质量发病率和死亡率数据,对女性乳腺癌的两年一次统计更新。乳腺癌发病率继续呈上升趋势,在 2012 年至 2021 年期间每年增长 1%,主要局限于局部阶段和激素受体阳性疾病。50 岁以下女性(每年增长 1.4%)与 50 岁及以上女性(总体增长 0.7%)之间的增长率差异更为显著,仅在白人女性中具有统计学意义。亚裔/太平洋岛裔女性在两个年龄段的增长率都最快(分别为每年 2.7%和 2.5%);因此,年轻的亚裔/太平洋岛裔女性在 2000 年的发病率最低(每 10 万人中有 57.4 人),但在 2021 年的发病率最高(每 10 万人中有 86.3 人),与白人女性(每 10 万人中有 86.4 人)相当,超过了黑人女性(每 10 万人中有 81.5 人)。相比之下,1989 年至 2022 年期间,乳腺癌总体死亡率持续下降了 44%,这意味着在此期间,乳腺癌死亡人数减少了 517900 人。然而,并非所有女性都受益于这一进展;自 1990 年以来,美洲印第安人/阿拉斯加原住民女性的死亡率一直保持不变,黑人女性的死亡率比白人女性高 38%,尽管发病率低 5%。尽管黑人和白人之间的差异部分反映了更多的三阴性癌症,但黑人女性的每种乳腺癌亚型和分期的存活率最低,除了局限性疾病,她们被诊断出患有乳腺癌的可能性比白人女性低 10%(58%比 68%),这突显了健康社会决定因素方面的劣势。通过改善临床试验代表性以及获得高质量的筛查和治疗,减轻种族、民族和社会差异,可能会加速乳腺癌防治的进展。