Recent Trends in Breast Cancer Among Younger Women in the United States
Recent Trends in Breast Cancer Among Younger Women in the United States
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DOI：
10.1093/jnci/djn344
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发表时间：
2008-11-19
影响因子：
10.3
通讯作者：
Anderson, William F.
中科院分区：
文献类型：
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作者：
Brinton, Louise A.;Sherman, Mark E.;Anderson, William F.
绝经后乳腺癌发病率的增加与筛查和绝经后激素的使用有关，但年轻女性受到的关注较少。因此，我们使用国家癌症研究所的监测、流行病学和最终结果计划13-注册数据库(1992-2004)分析了乳腺癌发病率的趋势(N=387231)。40岁以后，白人的发病率比黑人高，但年轻女性的情况正好相反(黑人和白人交叉)。在年轻妇女中，黑人每10万妇女年的发病率为16.8%，白人妇女为15.1%；30岁以下妇女的黑人-白人发病率比率(IRR)最高(IRR=1.52，95%可信区间=1.34-1.73)。这种风险模式在其他民族中没有观察到。年轻女性中的黑白交叉在很大程度上仅限于具有良好肿瘤特征的乳腺癌。浸润性乳腺癌发病率的年度变化在老年女性中略有下降，但在年轻(40岁)白人女性中有所增加。需要继续监测趋势，特别是在年轻女性中优先发生的分子亚型。
Increases in the incidence of postmenopausal breast cancers have been linked to screening and menopausal hormone use, but younger women have received less attention. Thus, we analyzed trends in breast cancer incidence (N = 387 231) using the National Cancer Institute's Surveillance, Epidemiology, and End Results Program 13-Registry database (1992-2004). Whites had higher incidence rates than blacks after age 40 years, but the reverse was true among younger women (black-white crossover). Among younger women, the rate per 100 000 woman-years was 16.8 for black vs 15.1 for white women; the highest black-white incidence rate ratio (IRR) was seen among women younger than 30 years (IRR = 1.52, 95% confidence interval = 1.34 to 1.73). This risk pattern was not observed in other ethnic groups. The black-white crossover among younger women was largely restricted to breast cancers with favorable tumor characteristics. The annual percentage change in the incidence of invasive breast cancers decreased modestly among older women but increased among younger (< 40 years) white women. Continued surveillance of trends is needed, particularly for molecular subtypes that preferentially occur among young women.