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Increase in Distant Stage Breast Cancer Incidence Rates in US Women Aged 25-49 Years, 2000-2011: The Stage Migration Hypothesis.

Polednak AP - J Cancer Epidemiol (2015)

Bottom Line: Background.The 3-year relative survival rate increased over time for distant stage (especially in the ER positive subgroup) and regional stage but not for localized stage; these trends do not contradict the stage-migration hypothesis.Conclusions.

View Article: PubMed Central - PubMed

Affiliation: Private Practice, 241 Stonecrest Drive, Bristol, CT 06010, USA.

ABSTRACT
Background. Unexplained increases have been reported in incidence rates for breast cancer diagnosed at distant stage in younger U.S. women, using data from the Surveillance, Epidemiology and End Results (SEER) Program. Methods. This report focused on recent SEER trends (2000-2011) in age-standardized incidence rates of invasive breast cancer at ages 25-39 and 40-49 years and the hypothesis that stage migration may have resulted from advances in detecting distant metastases at diagnosis. Results. Increases in the rates for distant stage were roughly equal to decreases in the rates for the most advanced stage subgroups within regional stage; this was evident for estrogen receptor (ER) negative cancers, associated with poorer prognosis, but not for ER positive cancers. The 3-year relative survival rate increased over time for distant stage (especially in the ER positive subgroup) and regional stage but not for localized stage; these trends do not contradict the stage-migration hypothesis. Conclusions. Findings provide some support for stage migration as one explanation for the recent increase in incidence of distant stage breast cancer, but additional studies are needed using other databases.

No MeSH data available.


Related in: MedlinePlus

Age-standardized incidence rate for breast cancer diagnosed at ages 25–39 years and 40–49 years in 2000–2011: distant summary stage versus SEER breast-adjusted AJCC 6th stage IIIC within regional summary stage.
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fig2: Age-standardized incidence rate for breast cancer diagnosed at ages 25–39 years and 40–49 years in 2000–2011: distant summary stage versus SEER breast-adjusted AJCC 6th stage IIIC within regional summary stage.

Mentions: Within regional summary stage, the ASIR for age 25–39 years for breast-adjusted AJCC stage IIIC declined (APC = −4.5%, P < .001, Table 1) (Figure 2), with a smaller decline for IIIB and no decline for IIIA or IIA-IIB (Table 1); the remainder were 144 coded as stage III not otherwise specified (NOS), 111 as other, and 475 as unknown (including 44 cases in 2000 and 46 in 2011) (data not tabulated). Within regional summary stage, the ASIR for age 40–49 years declined for breast-adjusted AJCC stage IIIC (APC = −3.7%, P < .001, Table 1) (Figure 2), with a smaller decline for stage IIIB (Table 1); the remainder were 341 coded as III-NOS, 390 as other, and 1362 as unknown (including 88 cases in 2000 and 87 in 2011) (data not tabulated). Using historic (instead of summary) regional stage, statistically significantly negative APCs in rates were also obtained for IIIC at ages 25–39 (total N = 1315 cases) and 40–49 years (total N = 3278 cases).


Increase in Distant Stage Breast Cancer Incidence Rates in US Women Aged 25-49 Years, 2000-2011: The Stage Migration Hypothesis.

Polednak AP - J Cancer Epidemiol (2015)

Age-standardized incidence rate for breast cancer diagnosed at ages 25–39 years and 40–49 years in 2000–2011: distant summary stage versus SEER breast-adjusted AJCC 6th stage IIIC within regional summary stage.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4306410&req=5

fig2: Age-standardized incidence rate for breast cancer diagnosed at ages 25–39 years and 40–49 years in 2000–2011: distant summary stage versus SEER breast-adjusted AJCC 6th stage IIIC within regional summary stage.
Mentions: Within regional summary stage, the ASIR for age 25–39 years for breast-adjusted AJCC stage IIIC declined (APC = −4.5%, P < .001, Table 1) (Figure 2), with a smaller decline for IIIB and no decline for IIIA or IIA-IIB (Table 1); the remainder were 144 coded as stage III not otherwise specified (NOS), 111 as other, and 475 as unknown (including 44 cases in 2000 and 46 in 2011) (data not tabulated). Within regional summary stage, the ASIR for age 40–49 years declined for breast-adjusted AJCC stage IIIC (APC = −3.7%, P < .001, Table 1) (Figure 2), with a smaller decline for stage IIIB (Table 1); the remainder were 341 coded as III-NOS, 390 as other, and 1362 as unknown (including 88 cases in 2000 and 87 in 2011) (data not tabulated). Using historic (instead of summary) regional stage, statistically significantly negative APCs in rates were also obtained for IIIC at ages 25–39 (total N = 1315 cases) and 40–49 years (total N = 3278 cases).

Bottom Line: Background.The 3-year relative survival rate increased over time for distant stage (especially in the ER positive subgroup) and regional stage but not for localized stage; these trends do not contradict the stage-migration hypothesis.Conclusions.

View Article: PubMed Central - PubMed

Affiliation: Private Practice, 241 Stonecrest Drive, Bristol, CT 06010, USA.

ABSTRACT
Background. Unexplained increases have been reported in incidence rates for breast cancer diagnosed at distant stage in younger U.S. women, using data from the Surveillance, Epidemiology and End Results (SEER) Program. Methods. This report focused on recent SEER trends (2000-2011) in age-standardized incidence rates of invasive breast cancer at ages 25-39 and 40-49 years and the hypothesis that stage migration may have resulted from advances in detecting distant metastases at diagnosis. Results. Increases in the rates for distant stage were roughly equal to decreases in the rates for the most advanced stage subgroups within regional stage; this was evident for estrogen receptor (ER) negative cancers, associated with poorer prognosis, but not for ER positive cancers. The 3-year relative survival rate increased over time for distant stage (especially in the ER positive subgroup) and regional stage but not for localized stage; these trends do not contradict the stage-migration hypothesis. Conclusions. Findings provide some support for stage migration as one explanation for the recent increase in incidence of distant stage breast cancer, but additional studies are needed using other databases.

No MeSH data available.


Related in: MedlinePlus