Annual Report to the Nation on the Status of Cancer, 1975-2011, Featuring Incidence of Breast Cancer Subtypes by Race/Ethnicity, Poverty, and State

Abstract

BackgroundThe American Cancer Society (ACS), Centers for Disease Control and Prevention (CDC), National Cancer Institute (NCI), and North American Association of Central Cancer Registries (NAACCR) collaborate annually to produce updated, national cancer statistics. This Annual Report includes a focus on breast cancer incidence by subtype using new, national-level data.MethodsPopulation-based cancer trends and breast cancer incidence by molecular subtype were calculated. Breast cancer subtypes were classified using tumor biomarkers for hormone receptor (HR) and human growth factor-neu receptor (HER2) expression.ResultsOverall cancer incidence decreased for men by 1.8% annually from 2007 to 2011. Rates for women were stable from 1998 to 2011. Within these trends there was racial/ethnic variation, and some sites have increasing rates. Among children, incidence rates continued to increase by 0.8% per year over the past decade while, like adults, mortality declined. Overall mortality has been declining for both men and women since the early 1990’s and for children since the 1970’s. HR+/HER2− breast cancers, the subtype with the best prognosis, were the most common for all races/ethnicities with highest rates among non-Hispanic white women, local stage cases, and low poverty areas (92.7, 63.51, and 98.69 per 100 000 non-Hispanic white women, respectively). HR+/HER2− breast cancer incidence rates were strongly, positively correlated with mammography use, particularly for non-Hispanic white women (Pearson 0.57, two-sided P < .001). Triple-negative breast cancers, the subtype with the worst prognosis, were highest among non-Hispanic black women (27.2 per 100 000 non-Hispanic black women), which is reflected in high rates in southeastern states.ConclusionsProgress continues in reducing the burden of cancer in the United States. There are unique racial/ethnic-specific incidence patterns for breast cancer subtypes; likely because of both biologic and social risk factors, including variation in mammography use. Breast cancer subtype analysis confirms the capacity of cancer registries to adjust national collection standards to produce clinically relevant data based on evolving medical knowledge.

Laryngeal cancer mortality trends in European countries

“…Similar trends in mortality from male laryngeal cancer were observed in the USA, where rates declined since the early 1990s, although over the last years the trends were levelling off (APC 5 2.3% in 2009-11). 15 Death certification for laryngeal cancer is sufficiently reliable to permit meaningful inference on trends for most European countries. 16,17 No major changes in the classification and coding of laryngeal cancer occurred across subsequent Revisions of the ICD, thus it is unlikely that mortality trends have been materially influenced by changes in diagnosis and certification of the disease.…”

How the future of clinical cancer diagnostics can contribute to overcoming race-associated cancer disparities

“…A growing body of evidence also support that there are race-associated differences in the molecular biology of cancer, with the likely consequence of expanding the diversity of molecular subtypes and contributing to disparities. Moreover, recent research studying somatic cancer gene mutations and copy number variation indicates that well-known and clinically actionable cancer-driver gene aberrations are overall found at significantly lower frequency in African American cancers [10][11][12]. Underscoring that somatic gene aberrations driving African American cancers remain understudied and possibly undocumented.…”

Consideration of geographic context in breast cancer in African American women

“…As breast cancer subtype data have become more accessible, researchers have examined the role of race and socioeconomic status in breast cancer subtype at the population level. [7][8][9] However, with the exception of the aforementioned article by Kohler et al, to my knowledge there is only limited research regarding population-level, geographic differences in breast cancer subtypes, especially the triple-negative subtype. 7 This suggests that geography may be an important additional factor that interplays with the cultural, social, economic, and biological factors indicated by Williams et al 1 In their study, Williams et al provide a thoughtful review of the social context of breast cancer for African American women.…”

“…[7][8][9] However, with the exception of the aforementioned article by Kohler et al, to my knowledge there is only limited research regarding population-level, geographic differences in breast cancer subtypes, especially the triple-negative subtype. 7 This suggests that geography may be an important additional factor that interplays with the cultural, social, economic, and biological factors indicated by Williams et al 1 In their study, Williams et al provide a thoughtful review of the social context of breast cancer for African American women. 1 To more completely address social context, geography needs to be considered as an additional key factor that contributes to breast cancer incidence generally,…”

“…The 2015 Annual Report to the Nation on the Status of Cancer indicated no significantly elevated rates of triple-negative breast cancer in any state compared with the national rate. 7 However, the authors found that the percentage of a state's population that is African American was significantly and positively correlated with rates of triple-negative breast cancer (Pearson r, 0.80 [P<.001] and Spearman q, 0.73 [P<.001]). As breast cancer subtype data have become more accessible, researchers have examined the role of race and socioeconomic status in breast cancer subtype at the population level.…”