The Decrease in Breast-Cancer Incidence in 2003 in the United States
Peter M. Ravdin, Ph.D., M.D., Kathleen A. Cronin, Ph.D., Nadia Howlader, M.S., Christine D. Berg, M.D., Rowan T. Chlebowski, M.D., Ph.D., Eric J. Feuer, Ph.D., Brenda K. Edwards, Ph.D., and Donald A. Berry, Ph.D.
An initial analysis of data from the National Cancer Institute'sSurveillance, Epidemiology, and End Results (SEER) registriesshows that the age-adjusted incidence rate of breast cancerin women in the United States fell sharply (by 6.7%) in 2003,as compared with the rate in 2002. Data from 2004 showed a levelingoff relative to the 2003 rate, with little additional decrease.Regression analysis showed that the decrease began in mid-2002and had begun to level off by mid-2003. A comparison of incidencerates in 2001 with those in 2004 (omitting the years in whichthe incidence was changing) showed that the decrease in annualage-adjusted incidence was 8.6% (95% confidence interval [CI],6.8 to 10.4). The decrease was evident only in women who were50 years of age or older and was more evident in cancers thatwere estrogen-receptorpositive than in those that wereestrogen-receptornegative. The decrease in breast-cancerincidence seems to be temporally related to the first reportof the Women's Health Initiative and the ensuing drop in theuse of hormone-replacement therapy among postmenopausal womenin the United States. The contributions of other causes to thechange in incidence seem less likely to have played a majorrole but have not been excluded.
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From the Department of Biostatistics, M.D. Anderson Cancer Center, Houston (P.M.R., D.A.B.); the Division of Cancer Control and Population Sciences (K.A.C., N.H., E.J.F., B.K.E.) and the Division of Cancer Prevention (C.D.B.), National Cancer Institute, Bethesda, MD; and the Los Angeles Biomedical Research Institute at HarborUCLA Medical Center, Torrance, CA (R.T.C.).
A Decline in Breast-Cancer Incidence
Bluming A. Z., Elfenbein G. J., Kliewer E. V., Demers A. A., Nugent Z. J., Zahl P.-H., Mæhlen J., Cady B., Chung M. A., Michaelson J. S., Robbins A. S., Clarke C. A., Signorello L. B., Tarone R. E., Ravdin P. M., Cronin K. A., Chlebowski R. T.
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N Engl J Med 2007;
357:509-513, Aug 2, 2007.
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