加拿大按年龄、分期和分子亚型、种族划分的乳腺癌发病率和死亡率。
Breast cancer incidence and mortality, by age, stage and molecular subtypes, by race/ethnicity in Canada.
作者信息
Wilkinson Anna N, Ng Carmina, Ellison Larry F, Seely Jean M
机构信息
Department of Family Medicine, University of Ottawa, Ottawa, Ontario, K1G 5Z3, Canada.
Centre for Population Health Data, Statistics Canada, Government of Canada, Ottawa, Ontario, K1A 0T6, Canada.
出版信息
Oncologist. 2024 Nov 2. doi: 10.1093/oncolo/oyae283.
BACKGROUND
Breast cancer (BC) characteristics and outcomes in Canada related to race/ethnicity are not currently documented.
METHODS
Age-specific and age-standardized BC incidence and mortality rates, age distribution of cases, proportions of stage, and molecular subtypes were calculated for women aged 20+, by race/ethnicity, using 2006 and 2011 Canadian Census Health and Environment Cohort databases of linked census, cancer, and death data.
RESULTS
In 47 105 BC cases, age-specific incidence rates were higher in Filipina (rate ratio (RR) = 1.27, 95%CI, 1.11-1.46) and multiethnicity (RR = 1.57, 95% CI, 1.18-2.08) compared to White women aged 40-49; and Filipina (RR = 1.16, 95% CI, 1.02-1.31) and Arab (RR = 1.3, 95% CI, 1.02-1.65) women aged 50-59. Median age at diagnosis was 63 among White women and 52-60 among other race/ethnicity groups, with 22.4%-41.1% of cases (P < .001) diagnosed before age 50 compared to 16.6% among White women. BC was diagnosed at stage I less frequently among Filipina (38.6%), Black (39.2%), South Asian (40.6%), and First Nations (40.7%) compared to White (46.5%) and Chinese (49.6%) (P < .05) women. Black women had higher proportions of BC diagnoses at stages III and IV combined (26.3%) than White women (17.0%, P = .001). The proportion of triple-negative BC among Black women (20.5%) was higher than among White (9.5%, P < .001). Compared to White, age-specific BC mortality rates were higher among Black women aged 40-49 (RR = 1.4, 1.06-1.85) as well as First Nations (RR = 1.21, 1.01-1.45) and Métis (RR = 1.48, 1.15-1.91) women aged 60-69.
INTERPRETATION
Compared to White women, other Canadian women had an earlier peak age of BC diagnosis and higher proportions of cases diagnosed under age 50. Although many race/ethnicity groups had lower BC incidence and mortality than White, the higher age-specific BC mortality among Black 40-49 and First Nations and Métis women 60-69 merits further investigation.
背景
目前加拿大缺乏关于乳腺癌（BC）特征及与种族/族裔相关的预后情况的记录。
方法
利用2006年和2011年加拿大人口普查健康与环境队列数据库（该数据库将人口普查、癌症和死亡数据相链接），按种族/族裔计算20岁及以上女性的特定年龄和年龄标准化的BC发病率及死亡率、病例的年龄分布、分期比例以及分子亚型。
结果
在47105例BC病例中，40 - 49岁的菲律宾女性（率比（RR）=1.27，95%置信区间（CI），1.11 - 1.46）和多族裔女性（RR =1.57，95% CI，1.18 - 2.08）的特定年龄发病率高于白人女性；50 - 59岁的菲律宾女性（RR =1.16，95% CI，1.02 - 1.31）和阿拉伯女性（RR =1.3，95% CI，1.02 - 1.65）的特定年龄发病率高于白人女性。白人女性的诊断中位年龄为63岁，其他种族/族裔群体为52 - 60岁，与白人女性中16.6%的病例在50岁前被诊断相比，其他种族/族裔群体中22.4% - 41.1%的病例在50岁前被诊断（P <.001）。与白人（46.5%）和华裔（49.6%）女性相比，菲律宾（38.6%）、黑人（39.2%）、南亚裔（40.6%）和原住民（40.7%）女性中I期BC的诊断频率较低（P <.05）。黑人女性中III期和IV期BC诊断合并比例（26.3%）高于白人女性（17.0%，P =.001）。黑人女性中三阴性BC的比例（20.5%）高于白人（9.5%，P <.001）。与白人相比，40 - 49岁的黑人女性以及60 - 69岁的原住民和梅蒂斯女性的特定年龄BC死亡率更高（黑人RR =1.4，1.06 - 1.85；原住民RR =1.21，1.01 - 1.45；梅蒂斯RR =1.48，1.15 - 1.91）。
解读
与白人女性相比,其他加拿大女性的BC诊断年龄峰值更早，50岁以下诊断病例的比例更高。尽管许多种族/族裔群体的BC发病率和死亡率低于白人，但40 - 49岁黑人以及60 - 69岁原住民和梅蒂斯女性中较高的特定年龄BC死亡率值得进一步研究。
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