Historical Trends in Incidence of Breast Cancer in Shanghai, Hong Kong and Los Angeles, 1973–2012: A Joinpoint and Age-Period-Cohort Analysis

Objectives: This study aimed to estimate the long-term trends of breast cancer incidence in Shanghai, Hong Kong, and Los Angeles (LA).Methods: Data were obtained from Cancer Incidence in Five Continents (CI5plus) database. The average annual percent change (AAPC) was conducted by joinpoint regression analysis, and the age, period and cohort effects were estimated by age-period-cohort (APC) analysis.Results: The age-standardized incidence rates (ASIRs) in LA were higher than Shanghai and Hong Kong. During 1988–2012, the ASIRs significantly decreased in white women in LA (AAPC = −0.6%, 95% CI: −0.9% to −0.4%) while increased in Shanghai (2.5%: 2.1%–2.9%) and Hong Kong (2.2%: 2.0%–2.5%). The APC analysis revealed significantly increased effects of age and period, and decreased effect of birth cohort.Conclusion: Although age and cohort effects were relatively strong, the period effect may be the key factor affecting trends of incidence, which may be caused by increasing exposures to carcinogens and risk factors. Therefore, more effective measures should be carried out promptly to protect high-risk populations such as elder women, to avoid exposures to risk factors of breast cancer.

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Trends in breast cancer incidence in Hong Kong between 1973 and 1999: an age-period-cohort analysis

British Journal of Cancer ◽

10.1038/sj.bjc.6600583 ◽

2002 ◽

Vol 87 (9) ◽

pp. 982-988 ◽

Cited By ~ 81

Author(s):

G M Leung ◽

T Q Thach ◽

T-H Lam ◽

A J Hedley ◽

W Foo ◽

...

Keyword(s):

Breast Cancer ◽

Hong Kong ◽

Cancer Incidence ◽

Cohort Analysis ◽

Breast Cancer Incidence

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Risk-based recommendations for mammographic screening for women in their forties.

Journal of Clinical Oncology ◽

10.1200/jco.1998.16.9.3105 ◽

1998 ◽

Vol 16 (9) ◽

pp. 3105-3114 ◽

Cited By ~ 44

Author(s):

M Gail ◽

B Rimer

Keyword(s):

Breast Cancer ◽

Risk Factors ◽

Black Women ◽

Cancer Incidence ◽

White Women ◽

Present Report ◽

Breast Cancer Incidence ◽

Mammographic Screening ◽

Incidence Rates ◽

Flow Diagram

PURPOSE To develop risk-based recommendations for mammographic screening for women in their 40s that take into account the woman's age, race, and specific risk factors. METHODS We assumed that regular mammographic screening is justified for a 50-year-old woman, even one with no risk factors, and that a younger woman with an expected 1-year breast cancer incidence rate as great or greater than that of a 50-year-old woman with no risk factors would benefit sufficiently to justify regular screening. Recommendations under this criterion were based on age- and race-specific breast cancer incidence rates from the National Cancer Institute's (NCI's) Surveillance, Epidemiology, and End Results (SEER) Program; assessments of risk factors from the Breast Cancer Detection and Demonstration Project (BCDDP); and reports in the literature. RESULTS Two methods, the exact-age procedure (EAP) and the grouped-age procedure (GAP), were developed. The less precise GAP only requires following a flow diagram. The proportion of white women recommended for screening by the EAP ranges from 10% for 40-year-old women to 95% for 49-year-old women, and the corresponding percentages for black women are 16% and 95%. The assumptions that underlie the guidelines are discussed critically. CONCLUSION For women or physicians who prefer an individualized approach in deciding whether to initiate regular mammographic screening in the age range of 40 to 49 years, the present report offers recommendations based on individualized risk-factor data and clearly stated assumptions that have an empiric basis. These recommendations can be used to facilitate the counseling process.

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