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Contrasting Epidemiology and Clinicopathology of Female Breast Cancer in Asians vs the US Population

Cited 77 time in Web of Science Cited 82 time in Scopus

Lin, Ching-Hung; Yap, Yoon Sim; Lee, Kyung-Hun; Im, Seock-Ah; Naito, Yoichi; Yeo, Winnie; Ueno, Takayuki; Kwong, Ava; Li, Huiping; Huang, Shu-Min; Leung, Roland; Han, Wonshik; Tan, Benita; Hu, Fu-Chang; Huang, Chiun-Sheng; Cheng, Ann-Lii; Lu, Yen-Shen; Asian Breast Cancer Cooperative Group; Noh, Dong Young

Issue Date
Oxford University Press
Journal of the National Cancer Institute, Vol.111 No.12, pp.1298-1306
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.
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  • Department of Medicine
Research Area Clinical Medicine


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