Breast cancer incidence patterns among California Hispanic women: differences by nativity and residence in an enclave.
Breast cancer incidence patterns among California Hispanic women: differences by nativity and residence in an enclave.
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DOI：
10.1158/1055-9965.epi-10-0021
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发表时间：
2010-05
期刊：
影响因子：
--
通讯作者：
Gomez SL
中科院分区：
文献类型：
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作者：
Keegan TH;John EM;Fish KM;Alfaro-Velcamp T;Clarke CA;Gomez SL
在美国出生的拉美裔女性的乳腺癌发病率高于在外国出生的拉美裔女性，但没有研究研究这些比率随着时间的推移是如何变化的。为了更好地为癌症控制工作提供信息，我们检查了按出生地和按社区社会经济地位(SES)和拉美裔飞地(拉美裔或拉美裔移民比例较高的社区)的发病率趋势。有关1988至2004年间所有被诊断为浸润性乳腺癌的西班牙裔妇女的信息都是从加州癌症登记处获得的。在27%的出生地信息缺失的案例中，出生地被归咎于社会安全号码。社区变量是从人口普查数据中开发出来的。从1988年到2004年，在美国出生的拉美裔美国人的发病率与非西班牙裔白人相当，但低于非拉美裔白人，从2002年到2004年每年下降6%。从1995年到1998年，在外国出生的拉美裔美国人的发病率每年增加4%，此后下降1.4%。在美国出生的拉美裔美国人的发病率比在外国出生的拉美裔人高38%，其中本地化疾病的发病率比地区性/远距离疾病和50岁的女性更明显。居住在较高的社会经济地位和较低的西班牙裔飞地社区独立地与更高的发病率相关，与西班牙裔飞地有更强的联系比社会经济地位。与在外国出生的拉美裔女性相比，加州出生的拉美裔女性乳腺癌风险因素的患病率更高，这表明发病率模式在很大程度上反映了这些风险因素的差异。需要进一步的研究来区分在这个庞大且不断增长的人口中影响发病率的个人和邻里层面因素的影响。
Breast cancer incidence is higher in US-born Hispanic women than foreign-born Hispanics, but no studies have examined how these rates have changed over time. To better inform cancer control efforts, we examined incidence trends by nativity and incidence patterns by neighborhood socioeconomic status (SES) and Hispanic enclave (neighborhoods with high proportions of Hispanics or Hispanic immigrants). Information regarding all Hispanic women diagnosed with invasive breast cancer between 1988 and 2004 were obtained from the California Cancer Registry. Nativity was imputed from Social Security number for the 27% of cases with missing birthplace information. Neighborhood variables were developed from Census data. From 1988 to 2004, incidence rates for US-born Hispanics were parallel, but lower than, those of non-Hispanic whites, showing an annual 6% decline from 2002 to 2004. Foreign-born Hispanics had an annual 4% increase in incidence rates from 1995 to 1998 and a 1.4% decline thereafter. Rates were 38% higher for US- than foreign-born Hispanics, with elevations more pronounced for localized than regional/distant disease, and for women > 50 years of age. Residence in higher SES and lower Hispanic enclave neighborhoods were independently associated with higher incidence, with Hispanic enclave having a stronger association than SES. Compared to foreign-born, US-born Hispanic women in California had higher prevalence of breast cancer risk factors, suggesting that incidence patterns largely reflects these differences in risk factors. Further research is needed to separate the effects of individual- and neighborhood-level factors that impact incidence in this large and growing population.