FREE NEJM E-TOC    HOME   |   SUBSCRIBE   |   CURRENT ISSUE   |   PAST ISSUES   |   COLLECTIONS   |   Search Term  Advanced Search

Sign in | Get NEJM's E-Mail Table of Contents — Free | Subscribe

Previous Volume 356:1670-1674 April 19, 2007 Number 16 Next

	Full Text PDF PDA Full Text Letters Add to Personal Archive Add to Citation Manager Notify a Friend E-mail When Cited E-mail When Letters Appear PubMed Citation

ABSTRACT

An initial analysis of data from the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) registries shows that the age-adjusted incidence rate of breast cancer in women in the United States fell sharply (by 6.7%) in 2003, as compared with the rate in 2002. Data from 2004 showed a leveling off relative to the 2003 rate, with little additional decrease. Regression analysis showed that the decrease began in mid-2002 and had begun to level off by mid-2003. A comparison of incidence rates in 2001 with those in 2004 (omitting the years in which the incidence was changing) showed that the decrease in annual age-adjusted incidence was 8.6% (95% confidence interval [CI], 6.8 to 10.4). The decrease was evident only in women who were 50 years of age or older and was more evident in cancers that were estrogen-receptor–positive than in those that were estrogen-receptor–negative. The decrease in breast-cancer incidence seems to be temporally related to the first report of the Women's Health Initiative and the ensuing drop in the use of hormone-replacement therapy among postmenopausal women in the United States. The contributions of other causes to the change in incidence seem less likely to have played a major role but have not been excluded.

Source Information

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 Harbor–UCLA Medical Center, Torrance, CA (R.T.C.).

Full Text of this Article

Related Letters:

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.
Extract | Full Text | PDF  
N Engl J Med 2007; 357:509-513, Aug 2, 2007. Correspondence

This article has been cited by other articles:

• Jorgensen, K. J., Gotzsche, P. C (2009). Overdiagnosis in publicly organised mammography screening programmes: systematic review of incidence trends. BMJ 339: b2587-b2587 [Abstract] [Full Text]  
• Banks, E., Canfell, K. (2009). Invited Commentary: Hormone Therapy Risks and Benefits--The Women's Health Initiative Findings and the Postmenopausal Estrogen Timing Hypothesis. Am J Epidemiol 170: 24-28 [Abstract] [Full Text]  
• Jemal, A., Siegel, R., Ward, E., Hao, Y., Xu, J., Thun, M. J. (2009). Cancer Statistics, 2009. CA Cancer J Clin 59: 225-249 [Abstract] [Full Text]  
• Lippman, S. M., Hawk, E. T. (2009). Cancer Prevention: From 1727 to Milestones of the Past 100 Years. Cancer Res. 69: 5269-5284 [Abstract] [Full Text]  
• Smith, B. D., Smith, G. L., Hurria, A., Hortobagyi, G. N., Buchholz, T. A. (2009). Future of Cancer Incidence in the United States: Burdens Upon an Aging, Changing Nation. JCO 27: 2758-2765 [Abstract] [Full Text]  
• Eheman, C. R., Shaw, K. M., Ryerson, A. B., Miller, J. W., Ajani, U. A., White, M. C. (2009). The Changing Incidence of In situ and Invasive Ductal and Lobular Breast Carcinomas: United States, 1999-2004. Cancer Epidemiol. Biomarkers Prev. 18: 1763-1769 [Abstract] [Full Text]  
• Onitilo, A. A., Engel, J. M., Greenlee, R. T., Mukesh, B. N. (2009). Breast Cancer Subtypes Based on ER/PR and Her2 Expression: Comparison of Clinicopathologic Features and Survival. Clin Med Res 7: 4-13 [Abstract] [Full Text]  
• Slanger, T. E., Chang-Claude, J. C., Obi, N., Kropp, S., Berger, J., Vettorazzi, E., Braendle, W., Bastert, G., Hentschel, S., Flesch-Janys, D. (2009). Menopausal Hormone Therapy and Risk of Clinical Breast Cancer Subtypes. Cancer Epidemiol. Biomarkers Prev. 18: 1188-1196 [Abstract] [Full Text]  
• Wang, Z., Wijewickrama, G. T., Peng, K.-w., Dietz, B. M., Yuan, L., van Breemen, R. B., Bolton, J. L., Thatcher, G. R. J. (2009). Estrogen Receptor {alpha} Enhances the Rate of Oxidative DNA Damage by Targeting an Equine Estrogen Catechol Metabolite to the Nucleus. J. Biol. Chem. 284: 8633-8642 [Abstract] [Full Text]  
• Greenwald, P., Dunn, B. K. (2009). Landmarks in the History of Cancer Epidemiology. Cancer Res. 69: 2151-2162 [Abstract] [Full Text]  
• Chlebowski, R. T., Kuller, L. H., Prentice, R. L., Stefanick, M. L., Manson, J. E., Gass, M., Aragaki, A. K., Ockene, J. K., Lane, D. S., Sarto, G. E., Rajkovic, A., Schenken, R., Hendrix, S. L., Ravdin, P. M., Rohan, T. E., Yasmeen, S., Anderson, G., the WHI Investigators, (2009). Breast Cancer after Use of Estrogen plus Progestin in Postmenopausal Women. NEJM 360: 573-587 [Abstract] [Full Text]  
• Harper, S., Lynch, J., Meersman, S. C., Breen, N., Davis, W. W., Reichman, M. C. (2009). Trends in Area-Socioeconomic and Race-Ethnic Disparities in Breast Cancer Incidence, Stage at Diagnosis, Screening, Mortality, and Survival among Women Ages 50 Years and Over (1987-2005). Cancer Epidemiol. Biomarkers Prev. 18: 121-131 [Abstract] [Full Text]  
• Jemal, A., Thun, M. J., Ries, L. A. G., Howe, H. L., Weir, H. K., Center, M. M., Ward, E., Wu, X.-C., Eheman, C., Anderson, R., Ajani, U. A., Kohler, B., Edwards, B. K. (2008). Annual Report to the Nation on the Status of Cancer, 1975-2005, Featuring Trends in Lung Cancer, Tobacco Use, and Tobacco Control. JNCI J Natl Cancer Inst 100: 1672-1694 [Abstract] [Full Text]  
• Kristal, A. R. (2008). Are Clinical Trials the "Gold Standard" for Cancer Prevention Research?. Cancer Epidemiol. Biomarkers Prev. 17: 3289-3291 [Full Text]  
• Bauchner, H. (2008). Atoms. Arch. Dis. Child. 93: i-i [Full Text]  
• Brinton, L. A., Richesson, D., Leitzmann, M. F., Gierach, G. L., Schatzkin, A., Mouw, T., Hollenbeck, A. R., Lacey, J. V. Jr. (2008). Menopausal Hormone Therapy and Breast Cancer Risk in the NIH-AARP Diet and Health Study Cohort. Cancer Epidemiol. Biomarkers Prev. 17: 3150-3160 [Abstract] [Full Text]  
• Ju, Y. H., Doerge, D. R., Woodling, K. A., Hartman, J. A., Kwak, J., Helferich, W. G. (2008). Dietary genistein negates the inhibitory effect of letrozole on the growth of aromatase-expressing estrogen-dependent human breast cancer cells (MCF-7Ca) in vivo. Carcinogenesis 29: 2162-2168 [Abstract] [Full Text]  
• Dawood, S., Broglio, K., Gonzalez-Angulo, A. M., Buzdar, A. U., Hortobagyi, G. N., Giordano, S. H. (2008). Trends in Survival Over the Past Two Decades Among White and Black Patients With Newly Diagnosed Stage IV Breast Cancer. JCO 26: 4891-4898 [Abstract] [Full Text]  
• Cheung, A. M (2008). Risk of cancer was still increased over 2 years after stopping hormone therapy. Evid. Based Med. 13: 142-142 [Full Text]  
• Linos, E., Spanos, D., Rosner, B. A., Linos, K., Hesketh, T., Qu, J. D., Gao, Y.-T., Zheng, W., Colditz, G. A. (2008). Effects of Reproductive and Demographic Changes on Breast Cancer Incidence in China: A Modeling Analysis. JNCI J Natl Cancer Inst 100: 1352-1360 [Abstract] [Full Text]  
• Eisen, A., Lubinski, J., Gronwald, J., Moller, P., Lynch, H. T., Klijn, J., Kim-Sing, C., Neuhausen, S. L., Gilbert, L., Ghadirian, P., Manoukian, S., Rennert, G., Friedman, E., Isaacs, C., Rosen, E., Rosen, B., Daly, M., Sun, P., Narod, S. A., the Hereditary Breast Cancer Clinical Study Group, (2008). Hormone Therapy and the Risk of Breast Cancer in BRCA1 Mutation Carriers. JNCI J Natl Cancer Inst 100: 1361-1367 [Abstract] [Full Text]  
• Chlebowski, R. T., Prentice, R. L. (2008). Menopausal Hormone Therapy in BRCA1 Mutation Carriers: Uncertainty and Caution. JNCI J Natl Cancer Inst 100: 1341-1343 [Full Text]  
• Hickey, M., Saunders, C., Partridge, A., Santoro, N., Joffe, H., Stearns, V. (2008). Practical clinical guidelines for assessing and managing menopausal symptoms after breast cancer. Ann Oncol 19: 1669-1680 [Abstract] [Full Text]  
• Garwood, E. R., Kumar, A. S., Shim, V. (2008). Menopausal Hormone Therapy and Breast Cancer Phenotype: Does Dose Matter?. Ann. Surg. Oncol. 15: 2526-2532 [Abstract] [Full Text]  
• Liby, K., Risingsong, R., Royce, D. B., Williams, C. R., Yore, M. M., Honda, T., Gribble, G. W., Lamph, W. W., Vannini, N., Sogno, I., Albini, A., Sporn, M. B. (2008). Prevention and Treatment of Experimental Estrogen Receptor-Negative Mammary Carcinogenesis by the Synthetic Triterpenoid CDDO-Methyl Ester and the Rexinoid LG100268. Clin. Cancer Res. 14: 4556-4563 [Abstract] [Full Text]  
• Jordan, V. C. (2008). The 38th David A. Karnofsky Lecture: The Paradoxical Actions of Estrogen in Breast Cancer--Survival or Death?. JCO 26: 3073-3082 [Abstract] [Full Text]  
• Chlebowski, R. T. (2008). Colorectal Cancer in Women After Stopping Postmenopausal Hormone Therapy--Reply. JAMA 299: 2744-2745 [Full Text]  
• Krieger, N. (2008). Hormone therapy and the rise and perhaps fall of US breast cancer incidence rates: critical reflections. Int J Epidemiol 37: 627-637 [Abstract] [Full Text]  
• Pfeiffer, R. M., Mitani, A., Matsuno, R. K., Anderson, W. F. (2008). Racial Differences in Breast Cancer Trends in the United States (2000-2004). JNCI J Natl Cancer Inst 100: 751-752 [Full Text]  
• Fountzilas, G., Dafni, U., Gogas, H., Linardou, H., Kalofonos, H. P., Briasoulis, E., Pectasides, D., Samantas, E., Bafaloukos, D., Stathopoulos, G. P., Karina, M., Papadimitriou, C., Skarlos, D., Pisanidis, N., Papakostas, P., Markopoulos, C., Tzorakoeleftherakis, E., Dimitrakakis, K., Makrantonakis, P., Xiros, N., Polichronis, A., Varthalitis, I., Karanikiotis, C., Dimopoulos, A. M. (2008). Postoperative dose-dense sequential chemotherapy with epirubicin, paclitaxel and CMF in patients with high-risk breast cancer: safety analysis of the Hellenic Cooperative Oncology Group randomized phase III trial HE 10/00. Ann Oncol 19: 853-860 [Abstract] [Full Text]  
• Hery, C., Ferlay, J., Boniol, M., Autier, P. (2008). Changes in breast cancer incidence and mortality in middle-aged and elderly women in 28 countries with Caucasian majority populations. Ann Oncol 19: 1009-1018 [Abstract] [Full Text]  
• Chu, D. Z. J. (2008). Re: Breast Cancer Incidence, 1980-2006: Combined Roles of Menopausal Hormone Therapy, Screening Mammography, and Estrogen Receptor Status. JNCI J Natl Cancer Inst 100: 596-597 [Full Text]  
• Caan, B., Habel, L., Quesenberry, C., Kushi, L., Herrinton, L. (2008). Re: Declines in Invasive Breast Cancer and Use of Postmenopausal Hormone Therapy in a Screening Mammography Population. JNCI J Natl Cancer Inst 100: 597-598 [Full Text]  
• Vaidya, J. S. (2008). Re: Declines in Invasive Breast Cancer and Use of Postmenopausal Hormone Therapy in a Screening Mammography Population. JNCI J Natl Cancer Inst 100: 598-599 [Full Text]  
• Arpino, G., Wiechmann, L., Osborne, C. K., Schiff, R. (2008). Crosstalk between the Estrogen Receptor and the HER Tyrosine Kinase Receptor Family: Molecular Mechanism and Clinical Implications for Endocrine Therapy Resistance. Endocr. Rev. 29: 217-233 [Abstract] [Full Text]  
• Fournier, A., Fabre, A., Mesrine, S., Boutron-Ruault, M.-C., Berrino, F., Clavel-Chapelon, F. (2008). Use of Different Postmenopausal Hormone Therapies and Risk of Histology- and Hormone Receptor-Defined Invasive Breast Cancer. JCO 26: 1260-1268 [Abstract] [Full Text]  
• Heiss, G., Wallace, R., Anderson, G. L., Aragaki, A., Beresford, S. A. A., Brzyski, R., Chlebowski, R. T., Gass, M., LaCroix, A., Manson, J. E., Prentice, R. L., Rossouw, J., Stefanick, M. L., for the WHI Investigators, (2008). Health Risks and Benefits 3 Years After Stopping Randomized Treatment With Estrogen and Progestin. JAMA 299: 1036-1045 [Abstract] [Full Text]  
• Trinkaus, M., Chin, S., Wolfman, W., Simmons, C., Clemons, M. (2008). Should Urogenital Atrophy in Breast Cancer Survivors Be Treated with Topical Estrogens?. The Oncologist 13: 222-231 [Abstract] [Full Text]  
• Jemal, A., Siegel, R., Ward, E., Hao, Y., Xu, J., Murray, T., Thun, M. J. (2008). Cancer Statistics, 2008. CA Cancer J Clin 0: CA.2007.0010v1-CA.2007.0010 [Abstract] [Full Text]  
• Eckstein, N., Servan, K., Girard, L., Cai, D., von Jonquieres, G., Jaehde, U., Kassack, M. U., Gazdar, A. F., Minna, J. D., Royer, H.-D. (2008). Epidermal Growth Factor Receptor Pathway Analysis Identifies Amphiregulin as a Key Factor for Cisplatin Resistance of Human Breast Cancer Cells. J. Biol. Chem. 283: 739-750 [Abstract] [Full Text]  
• Gralow, J., Ozols, R. F., Bajorin, D. F., Cheson, B. D., Sandler, H. M., Winer, E. P., Bonner, J., Demetri, G. D., Curran, W. Jr, Ganz, P. A., Kramer, B. S., Kris, M. G., Markman, M., Mayer, R. J., Raghavan, D., Ramsey, S., Reaman, G. H., Sawaya, R., Schuchter, L. M., Sweetenham, J. W., Vahdat, L. T., Davidson, N. E., Schilsky, R. L., Lichter, A. S. (2008). Clinical Cancer Advances 2007: Major Research Advances in Cancer Treatment, Prevention, and Screening--A Report From the American Society of Clinical Oncology. JCO 26: 313-325 [Abstract] [Full Text]  
• Tosteson, A. N.A., Stout, N. K., Fryback, D. G., Acharyya, S., Herman, B. A., Hannah, L. G., Pisano, E. D., for the DMIST Investigators, (2008). Cost-Effectiveness of Digital Mammography Breast Cancer Screening. ANN INTERN MED 148: 1-10 [Abstract] [Full Text]  
• Casey, P. M., Cerhan, J. R., Pruthi, S. (2008). Oral Contraceptive Use and the Risk of Breast Cancer. Mayo Clin Proc. 83: 86-91 [Abstract] [Full Text]  
• Robbins, A. S., Clarke, C. A. (2007). Re: Declines in Invasive Breast Cancer and Use of Postmenopausal Hormone Therapy in a Screening Mammography Population. JNCI J Natl Cancer Inst 99: 1815-1815 [Full Text]  
• Kerlikowske, K., Buist, D. S. M., Walker, R. (2007). Response: Re: Declines in Invasive Breast Cancer and Use of Postmenopausal Hormone Therapy in a Screening Mammography Population. JNCI J Natl Cancer Inst 99: 1816-1817 [Full Text]  
• Li, C. I., Daling, J. R. (2007). Changes in Breast Cancer Incidence Rates in the United States by Histologic Subtype and Race/Ethnicity, 1995 to 2004. Cancer Epidemiol. Biomarkers Prev. 16: 2773-2780 [Abstract] [Full Text]  
• Soerjomataram, I., Coebergh, J. W., Louwman, M. W.J., Visser, O., van Leeuwen, F. E. (2007). Does the Decrease in Hormone Replacement Therapy Also Affect Breast Cancer Risk in the Netherlands?. JCO 25: 5038-5039 [Full Text]  
• Jordan, V. C. (2007). Tamoxifen or Raloxifene for Breast Cancer Chemoprevention: A Tale of Two Choices Point. Cancer Epidemiol. Biomarkers Prev. 16: 2207-2209 [Full Text]  
• Sedjo, R. L., Byers, T., Barrera, E. Jr., Cohen, C., Fontham, E. T. H., Newman, L. A., Runowicz, C. D., Thorson, A. G., Thun, M. J., Ward, E., Wender, R. C., Eyre, H. J., for the ACS Cancer Incidence & Mortality Ends Comm, (2007). A Midpoint Assessment of the American Cancer Society Challenge Goal to Decrease Cancer Incidence by 25% Between 1992 and 2015. CA Cancer J Clin 57: 326-340 [Abstract] [Full Text]  
• Chang, M., Peng, K.-w., Kastrati, I., Overk, C. R., Qin, Z.-H., Yao, P., Bolton, J. L., Thatcher, G. R. J. (2007). Activation of Estrogen Receptor-Mediated Gene Transcription by the Equine Estrogen Metabolite, 4-Methoxyequilenin, in Human Breast Cancer Cells. Endocrinology 148: 4793-4802 [Abstract] [Full Text]  
• Fabian, C. J. (2007). Low-Dose Tamoxifen for Combination Hormone Replacement Therapy Users. JCO 25: 4162-4164 [Full Text]  
• Wacholder, S. (2007). Untangling Differences in Cancer Mortality Rates: A Closer Look at Race and Education. JNCI J Natl Cancer Inst 99: 1356-1357 [Full Text]  
• Kerlikowske, K., Miglioretti, D. L., Buist, D. S. M., Walker, R., Carney, P. A. (2007). Declines in Invasive Breast Cancer and Use of Postmenopausal Hormone Therapy in a Screening Mammography Population. JNCI J Natl Cancer Inst 99: 1335-1339 [Abstract] [Full Text]  
• Brinton, L. A., Lacey, J. V. Jr. (2007). Hormones and Breast Cancer: What's the Story?. Cancer Epidemiol. Biomarkers Prev. 16: 1697-1699 [Full Text]  
• Anderson, W. F., Reiner, A. S., Matsuno, R. K., Pfeiffer, R. M. (2007). Shifting Breast Cancer Trends in the United States. JCO 25: 3923-3929 [Abstract] [Full Text]  
• Bluming, A. Z., Elfenbein, G. J., Kliewer, E. V., Demers, A. A., Nugent, Z. J., Zahl, P.-H., Maehlen, 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. (2007). A Decline in Breast-Cancer Incidence. NEJM 357: 509-513 [Full Text]  
• Glass, A. G., Lacey, J. V. Jr, Carreon, J. D., Hoover, R. N. (2007). Breast Cancer Incidence, 1980 2006: Combined Roles of Menopausal Hormone Therapy, Screening Mammography, and Estrogen Receptor Status. JNCI J Natl Cancer Inst 99: 1152-1161 [Abstract] [Full Text]  
• Berry, D. A., Ravdin, P. M. (2007). Breast Cancer Trends: A Marriage Between Clinical Trial Evidence and Epidemiology. JNCI J Natl Cancer Inst 99: 1139-1141 [Full Text]  
• (2007). Did the WHI Results Affect Breast Cancer Incidence?. JWatch Oncology and Hematology 2007: 1-1 [Full Text]