Decline in US Breast Cancer Rates After the Women's Health Initiative: Socioeconomic and Racial/Ethnic Differentials
Decline in US Breast Cancer Rates After the Women's Health Initiative: Socioeconomic and Racial/Ethnic Differentials
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DOI：
10.2105/ajph.2009.181628
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发表时间：
2010-01-01
影响因子：
12.7
通讯作者：
Waterman, Pamela D.
中科院分区：
文献类型：
--
作者：
Krieger, Nancy;Chen, Jarvis T.;Waterman, Pamela D.
目标.我们调查了最近报道的美国乳腺癌发病率下降是否存在社会经济和种族/民族差异，这些下降归因于2002年后女性健康倡议研究发表后激素治疗使用的下降。我们分析了1992-2005年来自美国监测、流行病学和最终结果（SEER）13个登记数据库的美国乳腺癌发病率数据，按种族/民族、县收入水平、年龄和雌激素受体（ER）状态分层。正如我们假设的那样，在1992年至2005年期间，美国乳腺癌发病率上升然后下降的时间模式仅发生在居住在高收入县的白色非西班牙裔女性中，年龄在50岁及以上，并且具有ER阳性肿瘤。没有这样的趋势是明显的，无论县的收入水平，ER状态，或年龄之间的黑人非西班牙裔，亚洲/太平洋岛民，西班牙裔，或-其中的数字足以进行有意义的分析-美洲印第安人/阿拉斯加土著妇女。最近美国乳腺癌发病率的下降并不是对所有女性都同样有益，而是反映了激素治疗使用的社会模式。关于社会经济资源和种族/民族的联合信息对于正确理解疾病分布，包括乳腺癌的分布至关重要。(Am J公共卫生。2010;100：S132-S139。doi：10.2105/AJPH.2009.181628）
Objectives. We investigated whether there were socioeconomic and racial/ethnic disparities in recent reported declines in overall US breast cancer incidence rates attributed to post-2002 declines in hormone therapy use following publication of the Women's Health Initiative study.Methods. We analyzed 1992-2005 US breast cancer incidence data from the US Surveillance, Epidemiology and End Result (SEER) 13 Registries Database, stratified by race/ethnicity, county income level, age, and estrogen receptor (ER) status.Results. As we hypothesized, between 1992 and 2005, the temporal pattern of rising and then failing US breast cancer incidence rates occurred only among White non-Hispanic women who lived in high-income counties, were aged 50 years and older, and had ER-positive tumors. No such trends were evident-regardless of county income level, ER status, or age-among Black non-Hispanic, Asian/Pacific Islander, Hispanic, or-where numbers were sufficient to conduct meaningful analyses-American Indian/Alaska Native women.Conclusions. The recent decline in US breast cancer incidence was not equally beneficial to all women, but instead mirrored the social patterning of hormone therapy use. Joint information on socioeconomic resources and race/ethnicity is vital for correctly understanding disease distribution, including that of breast cancer. (Am J Public Health. 2010;100:S132-S139. doi:10.2105/AJPH.2009.181628)