Contrasting Epidemiology and Clinicopathology of Female Breast Cancer in Asians vs the US Population
Contrasting Epidemiology and Clinicopathology of Female Breast Cancer in Asians vs the US Population
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DOI：
10.1093/jnci/djz090
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发表时间：
2019-12-01
影响因子：
10.3
通讯作者：
Lu, Yen-Shen
中科院分区：
文献类型：
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作者：
Lin, Ching-Hung;Yap, Yoon Sim;Lu, Yen-Shen
背景：近几十年来，东亚年轻女性乳腺癌的发病率迅速上升。这项国际合作研究系统地比较了东亚女性和主要欧洲血统女性乳腺癌的年龄特异性发病率和病理特征的差异。方法：我们从六个国家癌症登记处摘录了分析数据，（979675宗个案）及八间医院（18008例），并从美国监测，流行病学和最终结果计划数据库进行比较。对女性乳腺癌的年龄特异性发病率进行线性回归分析，并对乳腺癌的年龄特异性病理特征进行Logistic回归分析。所有的统计检验都是双侧的。结果：与女性结直肠癌不同，东亚妇女年龄在59岁及以下的乳腺癌的年龄特异性发病率在近几十年来相对于美国同时代人的发病率增加。在2010-2014年期间，美国患者雌激素受体阳性的估计年龄特异性概率随着年龄的增长而增加，而三阴性乳腺癌（TNBC）的估计年龄特异性概率随着年龄的增长而下降。在东亚患者中没有明显的类似趋势; 40-49岁年龄组雌激素受体阳性的概率在统计学上显著高于（比值比[OR] = 1.50，95%置信区间[CI] = 1.36至1.67，P <0.001）和TNBC在统计学上显著低于（OR = 0.79，95%CI = 0.71 ~ 0.88，P <0.001），而50-59岁年龄段ER阳性的概率在统计学上显著较低（OR = 0.88，95%CI = 0.828 ~ 0.95，P <0.001）。美国监测，流行病学和最终结果数据的亚组分析显示，东亚美国人和白色美国patients.Conclusions：对比特定年龄的发病率和病理特征的乳腺癌之间的东亚和美国妇女，以及东亚美国人和白色美国人，表明种族差异的生物学。
Background: The incidence of breast cancer among younger East Asian women has been increasing rapidly over recent decades. This international collaborative study systemically compared the differences in age-specific incidences and pathological characteristics of breast cancer in East Asian women and women of predominantly European ancestry.Methods: We excerpted analytic data from six national cancer registries (979 675 cases) and eight hospitals (18 008 cases) in East Asian countries and/or regions and, for comparisons, from the US Surveillance, Epidemiology, and End Results program database. Linear regression analyses of age-specific incidences of female breast cancer and logistic regression analyses of age-specific pathological characteristics of breast cancer were performed. All statistical tests were two-sided.Results: Unlike female colorectal cancer, the age-specific incidences of breast cancer among East Asian women aged 59 years and younger increased disproportionally over recent decades relative to rates in US contemporaries. For years 2010-2014, the estimated age-specific probability of estrogen receptor positivity increased with age in American patients, whereas that of triple-negative breast cancer (TNBC) declined with age. No similar trends were evident in East Asian patients; their probability of estrogen receptor positivity at age 40-49 years was statistically significantly higher (odd ratio [OR] = 1.50, 95% confidence interval [CI] = 1.36 to 1.67, P < .001) and of TNBC was statistically significantly lower (OR = 0.79, 95% CI = 0.71 to 0.88, P < .001), whereas the probability of ER positivity at age 50-59 years was statistically significantly lower (OR = 0.88, 95% CI = 0.828 to 0.95, P < .001). Subgroup analyses of US Surveillance, Epidemiology, and End Results data showed similarly distinct patterns between East Asian American and white American patients.Conclusions: Contrasting age-specific incidences and pathological characteristics of breast cancer between East Asian and American women, as well as between East Asian Americans and white Americans, suggests racial differences in the biology.