Journal of the National Cancer Institute Advance Access published online on November 11, 2008
JNCI Journal of the National Cancer Institute, doi:10.1093/jnci/djn344
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Published by Oxford University Press 2008.
Recent Trends in Breast Cancer Among Younger Women in the United States
Affiliations of authors: Hormonal and Reproductive Epidemiology Branch (LAB, MES, JDC) and Biostatistics Branch (WFA), Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD
Correspondence to: Louise A. Brinton, PhD, Hormonal and Reproductive Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, 6120 Executive Blvd, Suite 550, Room 5018, Bethesda, MD 20852-7234 (e-mail: brinton{at}nih.gov).
Increases in the incidence of postmenopausal breast cancers have been linked to screening and menopausal hormone use, but younger women have received less attention. Thus, we analyzed trends in breast cancer incidence (N = 387 231) using the National Cancer Institute’s Surveillance, Epidemiology, and End Results Program 13-Registry database (1992–2004). Whites had higher incidence rates than blacks after age 40 years, but the reverse was true among younger women (black–white crossover). Among younger women, the rate per 100 000 woman-years was 16.8 for black vs 15.1 for white women; the highest black–white incidence rate ratio (IRR) was seen among women younger than 30 years (IRR = 1.52, 95% confidence interval = 1.34 to 1.73). This risk pattern was not observed in other ethnic groups. The black–white crossover among younger women was largely restricted to breast cancers with favorable tumor characteristics. The annual percentage change in the incidence of invasive breast cancers decreased modestly among older women but increased among younger (<40 years) white women. Continued surveillance of trends is needed, particularly for molecular subtypes that preferentially occur among young women.
| CONTEXT AND CAVEATS Prior knowledge Incidence of postmenopausal breast cancer has been associated with screening and hormone therapy, but the mechanisms involved in premenopausal breast cancer incidence have not been studied as extensively. Study design The incidence of breast cancer during 1992–2004 (N = 387 231 women) was compared among racial and ethnic groups and among age groups using data from the National Cancer Institute's Surveillance, Epidemiology, and End Results Program 13-Registry database. Contributions White women who were 40 years or older had a higher rate of breast cancer than black women in this age group, but among younger women the reverse was true (black–white crossover). The annual percentage change in invasive breast cancer incidence increased only among white women younger than 40 years. Implications Trends in breast cancer incidence and the subtypes that occur among young women should continue to be monitored. Limitations The results reported in this study differ from those of a previous study, which may be due to differences in the study population and the methods used. From the Editors
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None of the coauthors has a financial conflict of interest that would have affected this research. The authors had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.
Manuscript received February 21, 2008; revised August 20, 2008; accepted August 25, 2008.
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J Natl Cancer Inst 2008 100: 1561.
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