Estimation of the Number of Women Living with Metastatic Breast Cancer in the United States.
Estimation of the Number of Women Living with Metastatic Breast Cancer in the United States.
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DOI：
10.1158/1055-9965.epi-16-0889
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发表时间：
2017-06
期刊：
影响因子：
--
通讯作者：
Mayer M
中科院分区：
文献类型：
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作者：
Mariotto AB;Etzioni R;Hurlbert M;Penberthy L;Mayer M
远处转移性乳腺癌（MBC），包括诊断时发现的转移（新生）和后来发生的转移（复发），是该疾病最严重的形式，此时资源利用最为密集。但是，在美国，与MBC同居的女性人数是未知的。本文的目的是利用基于人口的数据来估计MBC的患病率。我们使用反向计算方法从监测、流行病学和最终结果（SEER）登记中估计美国BC死亡率和生存率的MBC患病率。基于疾病-死亡过程，该方法假设每个观察到的BC死亡都是MBC的结果，要么是新生，要么是转移性疾病的复发。我们估计，到2017年1月1日，美国将有154,794名女性患有MBC，其中4人中有3人最初被诊断为I-III期BC，后来进展为MBC。随着时间的推移，尤其是在年轻女性中，新发MBC的中位生存期和5年相对生存期都有所增加。我们估计，1992-1994年和2005-2012年期间，15-49岁被诊断为新发MBC的女性的5年相对生存率分别从18%增加到36%，增加了2倍。这项研究表明，美国越来越多的女性患有MBC，这可能是治疗方法改善和美国人口老龄化的结果。MBC日益增加的负担突出了记录复发的重要性，以便促进对这一未充分研究人群的具体需求进行更多的研究。
Distant metastatic breast cancer (MBC), including metastases found at diagnosis (de novo) and those occurring later (recurrence), represents the most severe form of the disease, when resource utilization is most intensive. Yet, the number of women living with MBC in the US is unknown. The objective of this paper is to use population-based data to estimate the prevalence of MBC. We used a back-calculation method to estimate MBC prevalence from US BC mortality and survival from the Surveillance, Epidemiology and End Results (SEER) registries. Based on the illness-death process, this method assumes that each observed BC death is the result of MBC, either de novo or a recurrence with metastatic disease. We estimate that by January 1, 2017 there will be 154,794 women living with MBC in the United States, 3 in 4 initially diagnosed with stage I–III BC who later progressed to MBC. Median survival and 5-year relative survival for de novo MBC increased over the years, especially in younger women. We estimate a 2-fold increase in 5-year relative survival from 18% to 36%, for women diagnosed with de novo MBC at age 15–49 between 1992–1994 and 2005–2012, respectively. This study demonstrates an increasing number of women in the US living with MBC, likely the result of improvements in treatment and aging of the US population. The increasing burden of MBC highlights the importance of documenting recurrence in order to foster more research into the specific needs of this understudied population.