Inter- and intra-ethnic differences for female breast carcinoma incidence in the continental United States and in the state of Hawaii

• Published in: Breast cancer research and treatment Vol. 97; no. 1; pp. 57 - 65
• Main Authors: MEGAN FONG, HENSON, Donald E, DEVESA, Susan S, ANDERSON, William F
• Format: Journal Article
• Language: English
• Published: Dordrecht Springer 01.05.2006; Springer Nature B.V
• Subjects: Adenocarcinoma - ethnology; Adenocarcinoma - etiology; Adenocarcinoma - pathology; Adenocarcinoma, Mucinous - ethnology; Adenocarcinoma, Mucinous - etiology; Adenocarcinoma, Mucinous - pathology; African Americans; Age; Age Distribution; Aged; Aged, 80 and over; Asian Americans; Biological and medical sciences; Breast cancer; Breast carcinoma; Breast Neoplasms - ethnology; Breast Neoplasms - etiology; Breast Neoplasms - pathology; Cancer research; Cancer therapies; Carcinoma, Ductal, Breast - ethnology; Carcinoma, Ductal, Breast - etiology; Carcinoma, Ductal, Breast - pathology; Cohort Studies; Cultural differences; Epidemiology; Ethnic Groups; European Continental Ancestry Group; Female; Gynecology. Andrology. Obstetrics; Hawaii - epidemiology; Humans; Incidence; Invasiveness; Mammary gland diseases; Medical sciences; Middle Aged; Minority & ethnic groups; Neoplasm Invasiveness; Neoplasm Staging; Neoplasms, Ductal, Lobular, and Medullary - ethnology; Neoplasms, Ductal, Lobular, and Medullary - etiology; Neoplasms, Ductal, Lobular, and Medullary - pathology; Odds Ratio; Pacific Islander people; Pacific Islands; Population Surveillance; Racial differences; Receptors, Estrogen - analysis; Receptors, Progesterone - analysis; Risk Factors; SEER Program; Survival Rate; Tumors; United States - epidemiology; Hawaii; United States; North America; Polynesia; America; Oceania; Pacific Islands; United States > US; Ethnic origin; racial diversity; hormone receptor expression; Breast cancer; Malignant tumor; age frequency distribution; Gene expression; Epidemiology; Ethnic group; Incidence; Mammary gland diseases; Breast carcinoma; age-specific incidence rates; Anatomic pathology; Histopathology; Race; Female; Frequency; Age; Age distribution; Hormonal receptor
• ISSN: 0167-6806; 1573-7217
• DOI: 10.1007/s10549-005-9088-5

Ethnic diversity is well-documented for female breast carcinoma incidence in the continental US but is not so well-established in the state of Hawaii. Using the Surveillance, Epidemiology, and End Results (SEER) program, we analyzed n=323,607 in situ and invasive female breast cancer cases for major ethnic groups in the continental US and in Hawaii, diagnosed during the years 1992-2002. In the continental US, age-specific incidence rate patterns and prognostic factor profiles were good-risk for Asian or Pacific Islanders (API), intermediate for Whites, and poor-risk for Blacks. For example, early age-at-onset, high nuclear grade, aggressive histopathologic subtypes, and hormone receptor negative expression was associated with Black race in the continental US. In Hawaii, age-specific rate and prognostic profiles were more favorable for API than for White women, albeit not so striking as in the continental US. We observed inter- and intra-ethnic differences for female breast carcinoma in the continental US and in the state of Hawaii. While inter-racial disparities were expected, intra-racial differences were somewhat unexpected and possibly due to variations in racial subgroup mixing and/or cultural assimilation. For example, API women with breast carcinoma in the continental US included 96.03% Asians and 2.4% Pacific Islanders. In contrast, API women with breast carcinoma in Hawaii included 76.52% Asians and 23.46% Pacific Islanders. Moreover, APIs were more likely to be first-generation migrants in the continental US ( approximately 92%) than in Hawaii ( approximately 34%). Future studies should attempt to disaggregate racial data to separately characterize epidemiological patterns for individual ethnic groups.