J Natl Cancer Inst. 2021 Sep 11:djab186. doi: 10.1093/jnci/djab186. Online ahead of print.
ABSTRACT
BACKGROUND: Incidence of estrogen receptor (ER)-negative breast cancer, an aggressive subtype, is highest in United States (US) African American women and in southern residents but has decreased overall since 1992. We assessed whether ER-negative breast cancer is decreasing in all age groups and cancer registries among non-Hispanic White (NHW), non-Hispanic Black (NHB), and Hispanic White (HW) women.
METHODS: We analyzed 17 Surveillance, Epidemiology, and End-Results Program registries (twelve for 1992-2016; five for 2000-2016) to assess NHW, NHB, and HW trends by ER status and age group (30-39, 40-49, 50-69, 70-84 years). We used hierarchical age-period-cohort models that account for sparse data, which improve estimates to quantify between-registry heterogeneity in mean incidence rates and age-adjusted trends versus SEER overall.
RESULTS: Overall, ER-negative incidence was highest in NHB, then NHW and HW women, and decreased from 1992-2016 in each age group and racial/ethnic group. The greatest decrease was for HW women ages 40-49 years with an annual percent change of -3.5%/year (95% credible interval = -4.4%, -2.7%), averaged over registries. The trend heterogeneity was statistically significant in every race/ethnic and age group. Furthermore, the incidence relative risks by race/ethnicity compared to the race-specific SEER average were also statistically significantly heterogeneous across the majority of registries and age groups (62 of 68 strata). The greatest heterogeneity was seen in HW women, followed by NHB women, and the least in NHW women.
CONCLUSION: Decreasing ER-negative breast cancer incidence differs meaningfully by US region and age among NHB and HW women. Analytical studies including minority women from higher and lower incidence areas may provide insights into breast cancer racial disparities.
PMID:34508608 | DOI:10.1093/jnci/djab186
