2017年刚过3/4，神刊已经公布了2017年的乳腺癌统计数据报告

　　2017年10月3日，影响因子高达187的美国癌症学会《临床医师癌症杂志》在线发表美国癌症学会和亨利福特医疗集团底特律总部的研究报告，提供了2017年美国女性乳腺癌统计概述，包括有关发病率、死亡率、生存率和筛查的数据。

　　2017年，美国女性预计将有25万2710例浸润性乳腺癌新病例、4万610例乳腺癌相关死亡病例。

　　发病率变化

　　2005～2014年，亚太地区岛屿居民、非西班牙裔黑人、西班牙裔女性的乳腺癌发病率每年分别增加1.7%、0.4%、0.3%，但是非西班牙裔白人、美洲印第安人、阿拉斯加原住民女性的乳腺癌发病率变化不大。

　　发病率增加主要由于所有种族民族人群的激素受体阳性乳腺癌发病率增加，但是激素受体阴性乳腺癌发病率减少。

　　死亡率变化

　　1989～2015年，乳腺癌相关死亡率减少39%，这意味着美国乳腺癌相关死亡人数减少32万2600例。

　　2006～2015年，所有种族民族人群的乳腺癌相关死亡率均减少，包括美洲印第安人、阿拉斯加原住民在内。

　　2011年以来，非西班牙裔黑人女性与非西班牙裔白人女性相比，乳腺癌相关死亡率较高，并且差距不断扩大，2015年高出39%（死亡率比：1.39，95%置信区间：1.35～1.43）。

　　2011～2015年，根据不同州份，黑人女性与白人女性相比，乳腺癌相关死亡率差距较大：

• 内华达州差距最小，相差20%（死亡率比：1.20，95%置信区间：1.01～1.42）

• 路易斯安那州差距最大，相差66%（死亡率比：1.66，95%置信区间：1.54～1.79）

　　值得注意的是，7个州的非西班牙黑人与非西班牙裔白人女性相比，乳腺癌相关死亡率相似，可能反映差距消除和/或统计学检验力不足。

　　因此，改善所有人群的医疗，可以消除乳腺癌相关死亡率的种族差距，并且加速全国乳腺癌相关死亡减少。

CA Cancer J Clin. 2017 Oct 3. [Epub ahead of print]

Breast cancer statistics, 2017, racial disparity in mortality by state.

DeSantis CE, Ma J, Goding Sauer A, Newman LA, Jemal A.

American Cancer Society, Atlanta, GA; Henry Ford Health System, Detroit, MI.

In this article, the American Cancer Society provides an overview of female breast cancer statistics in the United States, including data on incidence, mortality, survival, and screening. Approximately 252,710 new cases of invasive breast cancer and 40,610 breast cancer deaths are expected to occur among US women in 2017. From 2005 to 2014, overall breast cancer incidence rates increased among Asian/Pacific Islander (1.7% per year), non-Hispanic black (NHB) (0.4% per year), and Hispanic (0.3% per year) women but were stable in non-Hispanic white (NHW) and American Indian/Alaska Native (AI/AN) women. The increasing trends were driven by increases in hormone receptor-positive breast cancer, which increased among all racial/ethnic groups, whereas rates of hormone receptor-negative breast cancers decreased. From 1989 to 2015, breast cancer death rates decreased by 39%, which translates to 322,600 averted breast cancer deaths in the United States. During 2006 to 2015, death rates decreased in all racial/ethnic groups, including AI/ANs. However, NHB women continued to have higher breast cancer death rates than NHW women, with rates 39% higher (mortality rate ratio [MRR], 1.39; 95% confidence interval [CI], 1.35-1.43) in NHB women in 2015, although the disparity has ceased to widen since 2011. By state, excess death rates in black women ranged from 20% in Nevada (MRR, 1.20; 95% CI, 1.01-1.42) to 66% in Louisiana (MRR, 1.66; 95% CI, 1.54, 1.79). Notably, breast cancer death rates were not significantly different in NHB and NHW women in 7 states, perhaps reflecting an elimination of disparities and/or a lack of statistical power. Improving access to care for all populations could eliminate the racial disparity in breast cancer mortality and accelerate the reduction in deaths from this malignancy nationwide.

KEYWORDS: breast neoplasms; epidemiology; health disparities

PMID: 28972651

DOI: 10.3322/caac.21412