Breast Cancer Trends Among Black and White Women in the United States

Department of Surgery , Uniformed Services University of the Health Sciences, 베서스다, Maryland, United States
Journal of Clinical Oncology (Impact Factor: 18.43). 12/2005; 23(31):7836-41. DOI: 10.1200/JCO.2004.01.0421
Source: PubMed


Overall US breast cancer mortality rates are higher among black women than white women, and the disparity is widening. To investigate this disparity, we examined incidence data and changes in mortality trends according to age, year of death (calendar period), and date of birth (birth cohort). Calendar period mortality trends reflect the effects of new medical interventions, whereas birth cohort mortality trends reflect alterations in risk factors.
Incidence data were obtained from the Connecticut and National Cancer Institute Surveillance, Epidemiology, and End Results registries and mortality data were obtained from the National Center for Health Statistics. Changes in age, period, and cohort mortality trends were analyzed with Poisson regression.
For both races, breast cancer incidence rates for localized and regional disease diverged in the late 1970s. Almost concurrently, overall mortality rates diverged among blacks and whites. For both races, mortality increases with age, but blacks have higher mortality at age younger than 57. The calendar period curves revealed declining mortality for whites over the entire study period. For blacks, calendar period mortality declined until the late 1970s, and then sharply increased. After 1994, calendar period mortality declined for both. For women born between 1872 and 1950, trends in mortality were similar for blacks and whites. For women born after 1950, mortality decreased more rapidly for blacks.
The widening racial disparity in breast cancer mortality seems attributable to calendar period rather than birth cohort effects. Thus, differences in response or access to newer medical interventions may largely account for these trends.

Download full-text


Available from: Ismail Jatoi, Nov 06, 2015
  • Source
    • "However, few studies have predicted age-related changes in black/white breast cancer mortality. Jatoi et al. [9] used ageperiod-cohort (APC) models based on Poisson regression and observed the changes occurring in mortality trends among white "
    Dataset: Brca2010

    Full-text · Dataset · Jan 2015
  • Source
    • "Also, these models were applied in forecasting the mortality rates of chronic diseases such as breast cancer by Yasmeen et al. [5] [6]. The APC (age-period-cohort) models, one of the most commonly used statistical methods, were used to analyze trends for the mortality/incidence rates in demography and epidemiology [7]. These rates were observed over a long time period and for a broad age "
    [Show abstract] [Hide abstract]
    ABSTRACT: Abstract: Analysis, precise interpretation and forecasting of incidence and mortality rates are very important aspects in epidemiology and demography. The purpose of this study is to apply two different methodologies, namely the FTS (functional time series) models and APC (age-period-cohort) models on a single data set. We intend to compare the results obtained and to see the performances of these two approaches. We used FTS models on age-specific incidence rates taking age as a continuous function that is varying by time. Here we examined the age variations by using FPC (functional principal component) analysis. We also obtained the forecast of the entire incidence curve. Then we applied the APC models on the same data where we explored the age, period and cohort effects separately. We illustrated these approaches by using lung cancer incidence rates for males in Denmark, obtained from R-package “Epi” available on CRAN (Comprehensive R Archive Network). It was found that there was a rapid increase in lung cancer incidence rates in Denmark since 1960, and the highest rates were seen in the year 1985. After that, the rates started to level off. A continuous increment was also found in incidence rates since 1958 birth cohorts. These rates stabilized in 1905 and started decreasing since 1925. The first four basis functions of the FTS model explained about 98.5%, 1.2%, 0.2%, and 0.1% of the total variation, respectively. We also obtained 20-year predictions and suggested that future trends for the male lung cancer incidence rates in Denmark will decrease in all ages.
    Full-text · Article · Jul 2014
  • Source
    • "For instance, women with ER-positive breast cancers have a better prognosis and are candidates for hormone therapy [66,68]. Improved breast cancer awareness and access to effective diagnosis and treatment played an important role in improving early diagnosis and survival in high-income countries before the introduction of widespread mammography screening [69-71]. Improving surgical and radiotherapy facilities and the feasibility to administer systemic therapies in health services will increase breast cancer survival significantly in many Asian countries [19,20,66]. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Asia accounts for 60% of the world population and half the global burden of cancer. The incidence of cancer cases is estimated to increase from 6.1 million in 2008 to 10.6 million in 2030, due to ageing and growing populations, lifestyle and socioeconomic changes. Striking variations in ethnicity, sociocultural practices, human development index, habits and dietary patterns are reflected in the burden and pattern of cancer in different regions. The existing and emerging cancer patterns and burden in different regions of Asia call for political recognition of cancer as an important public health problem and for balanced investments in public and professional awareness. Prevention as well as early detection of cancers leads to both better health outcomes and considerable savings in treatment costs. Cancer health services are still evolving, and require substantial investment to ensure equitable access to cancer care for all sections of the population. In this review, we discuss the changing burden of cancer in Asia, along with appropriate management strategies. Strategies should promote healthy ageing via healthy lifestyles, tobacco and alcohol control measures, hepatitis B virus (HBV) and human papillomavirus (HPV) vaccination, cancer screening services, and vertical investments in strengthening cancer healthcare infrastructure to improve equitable access to services.
    Preview · Article · Jan 2014 · BMC Medicine
Show more