Breast cancer incidence increasing among young women
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The incidence of breast cancer amount young women has increased in recent decades, according to research presented at ASCO 2021.
“Breast cancer incidence increased among U.S. women aged 20 to 49 years from 1993 to 2017, largely driven by increase in ER+ tumors,” Shuai Xu, MPH, a statistical data analyst in the division of public health science at the department of surgery at Washington University School of Medicine, told Healio. “Age-specific breast cancer incidence rates increased across the recent birth cohorts.”
Using data collected from the Surveillance, Epidemiology, and End Results (SEER) 13 registries from 1993 to 2002 and SEER 18 registries from 2003 to 2017, researchers determined age-standardized incidence rates and annual change among women aged 20 to 49 years who were diagnosed with primary invasive breast cancer. These calculations were stratified by patient’ race/ethnicity, hormone receptor status and tumor state.
The analyses included a total of 222,424 women.
Xu and colleagues found that from 2010 to 2017, the incidence of invasive breast cancer rose among young women following a period of stability from 1993 to 2010, with an annual percent change of 0.67% (95% CI, 0.32-1.03).
They also identified differences in invasive breast cancer incidence by patients’ race, with significant increases in annual percent chance among non-Hispanic white patients (0.25%; 95% CI, 0.16-0.34), non-Hispanic Asia/Pacific Islander (0.58%; 95% CI, 0.34-0.82) and Hispanic women (0.59%; 95% CI, 0.34-0.83), but not among non-Hispanic Black women.
Additionally, Xu and colleagues determined that the incidence of ER+ tumors increased among women aged 20 to 49 years, while the prevalence of ER– tumors decreased among this patient population. They found that the annual percent change increased for ER+/PR+ tumors (2.39%; 95% CI, 2.2-2.58) and ER+/PR– (1.46%; 95% CI; 1.05-1.87), but decreased for ER–/PR+ tumors (–6.33%; 95% CI; –7.31 to –5.33) and ER–/PR– tumors (–0.70%; 95% CI, –1.09 to –0.32)
According to the researchers, the observed decrease in ER–/PR– tumors was largely caused by decreases in Hispanic non-white women.
They also found that, while the annual percent change in incidence of stage I (0.31; 95% CI, 0.07-0.55), stage II tumors (0.99; 95% CI, 0.82-1.16), and stage IV tumors (2.88; 95% CI, 2.37-3.39), the incidence of diagnoses of stage III tumors decreased (0.81%, 95% CI, –1.04 to –0.59).
Xu and colleagues determined that age-specific relative risk decreased from 1948 to 1958, but increased from 1958 to 1993, with increased breast cancer incidence among those born in 1988 (IRR = 1.17; 95% CI, 1.07-1.28) and 1993 (IRR = 1.22; 95% CI, 0.99-1.51) compared with those born in 1948.
“It will be crucial to identify factors driving this increase and tailor preventive efforts to address this,” Xu said. “Although the risk factors differ, we can learn a lot from what has worked for decreasing in ER– tumors and apply this knowledge to ER+ tumors.”
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