Changes in breast cancer incidence rates in the united states by histologic subtype and race/ethnicity, 1995 to 2004
Changes in breast cancer incidence rates in the united states by histologic subtype and race/ethnicity, 1995 to 2004
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DOI：
10.1158/1055-9965.epi-07-0546
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发表时间：
2007-12-01
影响因子：
3.8
通讯作者：
Daling, Janet R.
中科院分区：
文献类型：
--
作者：
Li, Christopher I.;Daling, Janet R.
美国的乳腺癌发病率在整个20世纪80年代和90年代都在上升，但最近到2004年有所下降。报告这种下降的研究主要归因于妇女健康倡议试验结果发表后绝经期激素使用的急剧下降。然而，他们没有按照组织学类型或人种/种族对发生率进行分层，这可能进一步为这些趋势的贡献者提供信息。使用来自13个参与监测、流行病学和最终结果项目的癌症登记处的数据，我们评估了1995年至2004年乳腺癌发病率的年度百分比变化（APC），这些变化按组织学类型和人种/种族进行，并使用联合点回归确定间隔。浸润性导管癌和浸润性小叶癌的发病率从1998年到2004年稳步下降[APC，分别为-3.07%（95%置信区间，-4.10至-2.02）和-3.18%（95%置信区间，-5.18至-1.03）]。总体乳腺癌和浸润性导管癌发病率的下降主要限于≥ 50岁的女性和非西班牙裔白人以及亚洲/太平洋岛民，浸润性小叶癌发病率的下降主要限于非西班牙裔白人。这些下降大部分开始于1998年左右，并且都开始于2002年妇女健康倡议试验结果公布之前;因此，2002年开始的激素治疗使用的突然下降不太可能是最近乳腺癌发病率下降的主要原因。到目前为止观察到的下降可能是由于筛查的饱和，尽管可能会出现与广泛停止使用激素有关的进一步下降。
Breast cancer incidence rates rose throughout the 1980s and 1990s in the United States but have recently declined through 2004. Studies reporting this decline primarily attribute it to the sharp decline in menopausal hormone use following publication of the Women's Health Initiative trial results. However, they have not stratified rates by either histologic type or race/ethnicity, which could further inform contributors to these trends. Using data from 13 cancer registries that participate in the Surveillance, Epidemiology, and End Results program, we evaluated annual percent changes (APC) in breast cancer incidence rates from 1995 to 2004 by histologic type and race/ethnicity for intervals identified using joinpoint regression. Invasive ductal carcinoma and invasive lobular carcinoma incidence rates fell steadily from 1998 to 2004 [APC, -3.07% (95% confidence interval, -4.10 to -2.02) and APC, -3.18% (95% confidence interval, -5.18 to -1.03), respectively]. Declines in rates of breast cancer overall and invasive ductal carcinoma were primarily limited to women >= 50 years of age and to non-Hispanic whites and Asian/ Pacific Islanders, and declines in rates of invasive lobular carcinoma were primarily limited to non-Hispanic whites. The majority of these declines began around 1998 and all began before 2002 when the Women's Health Initiative trial results were published; thus, the abrupt decline in hormone therapy use starting in 2002 is unlikely to be primarily responsible for the recent decline in breast cancer rates. The declines observed thus far are likely attributable to saturation of screening, although further declines related to the widespread cessation of hormone use may follow.