Incidence of Breast Cancer in the United States: Current and Future Trends
Incidence of Breast Cancer in the United States: Current and Future Trends
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DOI：
10.1093/jnci/djr257
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发表时间：
2011-09-01
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影响因子：
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通讯作者：
Rosenberg, Philip S.
中科院分区：
文献类型：
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作者：
Anderson, William F.;Katki, Hormuzd A.;Rosenberg, Philip S.
在美国，乳腺癌的发病率一直在上升，直到2000年左右，然后下降，主要发生在雌激素受体（ER）阳性癌症的女性中。时间趋势为癌症病因学和预防提供了重要线索;然而，观察到的ER阳性和ER阴性乳腺癌的趋势可能会因ER缺失数据而产生偏差。方法我们开发了一种简单的插补方法来校正ER缺失或未知表达的浸润性女性乳腺癌发病率，使用来自国家癌症研究所的监测，流行病学，1980-2008年期间，包括588 720例浸润性女性乳腺癌患者，随访471 336 233女性年。ER阳性和ER阴性乳腺癌的校正率被用来计算年龄标准化发病率，估计每年的百分比变化，并预测来自年龄期队列models.Results乳腺癌的发病率总体上稳定在2007-2008年每10万妇女年近200人，反映了ER阳性癌症的短暂减少和ER阴性癌症的稳定减少。预计到2016年，乳腺癌的总体发病率与2007-2008年期间的发病率相似。相比之下，ER阳性乳腺癌的发病率预计将增加5.3%，（95%置信区间= 5.2%至5.4%），而ER阴性乳腺癌的发病率预计将下降11.4%，（95%置信区间= 11.3%至11.6%）结论乳腺癌发病率的近期变化总体上反映了ER阳性和ER阴性癌症的不同趋势的叠加。如果目前的趋势继续下去，ER阳性乳腺癌的发病率将增加，ER阴性乳腺癌的发病率将继续下降，乳腺癌的总体发病率将保持与目前水平相似。
Background The incidence of breast cancer increased in the United States until circa 2000 then decreased, mostly among women with estrogen receptor (ER)-positive cancers. Time trends provide important clues for cancer etiology and prevention; however, the observed trends of ER-positive and ER-negative breast cancers can be biased by missing ER data.Methods We developed a simple imputation method to correct invasive female breast cancer incidence for missing or unknown ER expression, using nationally representative data from the National Cancer Institute's Surveillance, Epidemiology, and End Results Program during 1980-2008, including 588 720 invasive female breast cancer patients with 471 336 233 woman-years of follow-up. Corrected rates of ER-positive and ER-negative breast cancers were used to calculate age-standardized incidence rates, estimated annual percentage changes, and projections derived from age-period-cohort models.Results The recent decrease in the incidence of breast cancer overall stabilized near 200 per 100 000 woman-years by 2007-2008, reflecting a transient decrease in ER-positive cancers and a steady decrease in ER-negative cancers. The projected incidence rate for breast cancer overall through the year 2016 was similar to the incidence rate during 2007-2008. In contrast, rates of ER-positive breast cancers were projected to increase 5.3% (95% confidence interval = 5.2% to 5.4%), whereas rates of ER-negative breast cancers were projected to decrease 11.4% (95% confidence interval = 11.3% to 11.6%) during 2009-2016.Conclusion Recent changes in breast cancer incidence overall reflect the superimposition of divergent trends in ER-positive and ER-negative cancers. If current trends continue, the incidence of ER-positive breast cancers will increase, the incidence of ER-negative breast cancers will continue to decrease, and the incidence of breast cancer overall will remain similar to its current level.