Declining Incidence of Contralateral Breast Cancer in the United States From 1975 to 2006
Declining Incidence of Contralateral Breast Cancer in the United States From 1975 to 2006
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DOI：
10.1200/jco.2010.32.7395
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发表时间：
2011-04-20
影响因子：
45.3
通讯作者：
Anderson, William F.
中科院分区：
文献类型：
--
作者：
Nichols, Hazel B.;de Gonzalez, Amy Berrington;Anderson, William F.
乳腺癌是首次确诊的乳腺癌患者中最常见的新发恶性肿瘤。虽然第一乳腺癌的时间趋势已经得到很好的研究，CBC的趋势并没有那么好established.Patients和MethodsWe检查CBC发病率的时间趋势，使用美国监测，流行病学和最终结果数据库（1975年至2006年）。数据分层的雌激素受体（ER）状态的第一个乳腺癌的可用时间段（1990+）。我们使用Poisson回归模型估计CBC发病率的年百分比变化（EAPC），该模型根据首次乳腺癌诊断时的年龄和时间进行了调整。（EAPC，每年0.27%; 95% CI，-0.4至0.9），之后下降，EAPC为每年-3.07%（95% CI，-3.5至-2.7）。从1990年开始，ER阳性癌症后CBC下降仅限于EAPC，-3.18%; 95%CI，-4.2至-2.2），ER阴性癌症后没有明显下降。ER阳性首次癌症后估计的当前年龄特异性CBC率（每100人/年）为：30岁之前诊断的首次癌症为0.45，30岁或以上为0.25至0.37。ER阴性癌症后的发病率更高：1.26岁之前30岁，0.85岁30至35岁，0.45至0.65岁40岁或以上。ConclusionResults显示，自1985年以来，CBC的发病率每年下降3%。这一总体趋势是由ER阳性癌症后CBC率下降驱动的，可能是由于1983年Nolvadex佐剂试验组织发表结果后广泛使用辅助激素治疗和/或其他辅助治疗。J Clin Oncol 29：1564-1569. (C)2011年美国临床肿瘤学会
PurposeContralateral breast cancer (CBC) is the most frequent new malignancy among women diagnosed with a first breast cancer. Although temporal trends for first breast cancers have been well studied, trends for CBC are not so well established.Patients and MethodsWe examined temporal trends in CBC incidence using US Surveillance, Epidemiology, and End Results database (1975 to 2006). Data were stratified by estrogen receptor (ER) status of the first breast cancer for the available time period (1990+). We estimated the annual percent change (EAPC) in CBC rates using Poisson regression models adjusted for the age at and time since first breast cancer diagnosis.ResultsBefore 1985, CBC incidence rates were stable (EAPC, 0.27% per year; 95% CI, -0.4 to 0.9), after which they declined with an EAPC of -3.07% per year (95% CI, -3.5 to -2.7). From 1990 forward, the declines were restricted to CBC after an ER-positive cancer (EAPC, -3.18%; 95% CI, -4.2 to -2.2) with no clear decreases after an ER-negative cancer. Estimated current age-specific CBC rates (per 100/year) after an ER-positive first cancer were: 0.45 for first cancers diagnosed before age 30 years and 0.25 to 0.37 for age 30 years or older. Rates after an ER-negative cancer were higher: 1.26 before age 30 years, 0.85 for age 30 to 35 years, and 0.45 to 0.65 for age 40 or older.ConclusionResults show a favorable decrease of 3% per year for CBC incidence in the United States since 1985. This overall trend was driven by declining CBC rates after an ER-positive cancer, possibly because of the widespread usage of adjuvant hormone therapies, after the results of the Nolvadex Adjuvant Trial Organisation were published in 1983, and/or other adjuvant treatments. J Clin Oncol 29:1564-1569. (C) 2011 by American Society of Clinical Oncology