Tags

Type your tag names separated by a space and hit enter

Geographic variation in breast cancer incidence rates in a cohort of U.S. women.
J Natl Cancer Inst 1997; 89(18):1373-8JNCI

Abstract

BACKGROUND

Breast cancer mortality and incidence rates vary by geographic region in the United States. Previous analytic studies have measured mortality, not incidence, and have used regional prevalences to control for geographic variation in risk factors rather than adjusting for risk factors measured at the level of the individual. We prospectively evaluated regional variation in breast cancer incidence rates in the Nurses' Health Study and assessed the influence of breast cancer risk factors measured at the individual level.

METHODS

The Nurses' Health Study cohort was established in 1976 when 121700 female nurses aged 30-55 years living in 11 U.S. states were enrolled. These states represent all four regions of the continental United States. We identified 3603 incident cases of invasive breast cancer through 1992 (1794565 person-years of follow-up). We calculated relative risks (RRs) adjusted for age and for age and established risk factors (i.e., multivariate-adjusted analysis), comparing California, the Northeast, and the Midwest with the South.

RESULTS

For premenopausal women, there was little evidence of regional variation in breast cancer incidence rates, either in age-adjusted or in multivariate-adjusted analyses. For postmenopausal women in California, age-adjusted risk was modestly elevated (RR = 1.24; 95% confidence interval [CI] = 1.05-1.47); after adjusting for age and for established risk factors, the excess rate in California was attenuated by 25% (RR = 1.18; 95% CI = 1.00-1.40). No excess of breast cancer incidence was observed for postmenopausal women in either the Northeast or the Midwest.

CONCLUSIONS

Little regional variation in age-adjusted breast cancer incidence rates was observed, with the exception of a modest excess for postmenopausal women in California. Adjustment for differences in the distribution of established risk factors explained some of the excess risk in California.

Authors+Show Affiliations

Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA 02115, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

9308708

Citation

Laden, F, et al. "Geographic Variation in Breast Cancer Incidence Rates in a Cohort of U.S. Women." Journal of the National Cancer Institute, vol. 89, no. 18, 1997, pp. 1373-8.
Laden F, Spiegelman D, Neas LM, et al. Geographic variation in breast cancer incidence rates in a cohort of U.S. women. J Natl Cancer Inst. 1997;89(18):1373-8.
Laden, F., Spiegelman, D., Neas, L. M., Colditz, G. A., Hankinson, S. E., Manson, J. E., ... Hunter, D. J. (1997). Geographic variation in breast cancer incidence rates in a cohort of U.S. women. Journal of the National Cancer Institute, 89(18), pp. 1373-8.
Laden F, et al. Geographic Variation in Breast Cancer Incidence Rates in a Cohort of U.S. Women. J Natl Cancer Inst. 1997 Sep 17;89(18):1373-8. PubMed PMID: 9308708.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Geographic variation in breast cancer incidence rates in a cohort of U.S. women. AU - Laden,F, AU - Spiegelman,D, AU - Neas,L M, AU - Colditz,G A, AU - Hankinson,S E, AU - Manson,J E, AU - Byrne,C, AU - Rosner,B A, AU - Speizer,F E, AU - Hunter,D J, PY - 1997/10/6/pubmed PY - 1997/10/6/medline PY - 1997/10/6/entrez SP - 1373 EP - 8 JF - Journal of the National Cancer Institute JO - J. Natl. Cancer Inst. VL - 89 IS - 18 N2 - BACKGROUND: Breast cancer mortality and incidence rates vary by geographic region in the United States. Previous analytic studies have measured mortality, not incidence, and have used regional prevalences to control for geographic variation in risk factors rather than adjusting for risk factors measured at the level of the individual. We prospectively evaluated regional variation in breast cancer incidence rates in the Nurses' Health Study and assessed the influence of breast cancer risk factors measured at the individual level. METHODS: The Nurses' Health Study cohort was established in 1976 when 121700 female nurses aged 30-55 years living in 11 U.S. states were enrolled. These states represent all four regions of the continental United States. We identified 3603 incident cases of invasive breast cancer through 1992 (1794565 person-years of follow-up). We calculated relative risks (RRs) adjusted for age and for age and established risk factors (i.e., multivariate-adjusted analysis), comparing California, the Northeast, and the Midwest with the South. RESULTS: For premenopausal women, there was little evidence of regional variation in breast cancer incidence rates, either in age-adjusted or in multivariate-adjusted analyses. For postmenopausal women in California, age-adjusted risk was modestly elevated (RR = 1.24; 95% confidence interval [CI] = 1.05-1.47); after adjusting for age and for established risk factors, the excess rate in California was attenuated by 25% (RR = 1.18; 95% CI = 1.00-1.40). No excess of breast cancer incidence was observed for postmenopausal women in either the Northeast or the Midwest. CONCLUSIONS: Little regional variation in age-adjusted breast cancer incidence rates was observed, with the exception of a modest excess for postmenopausal women in California. Adjustment for differences in the distribution of established risk factors explained some of the excess risk in California. SN - 0027-8874 UR - https://www.unboundmedicine.com/medline/citation/9308708/Geographic_variation_in_breast_cancer_incidence_rates_in_a_cohort_of_U_S__women_ L2 - https://academic.oup.com/jnci/article-lookup/doi/10.1093/jnci/89.18.1373 DB - PRIME DP - Unbound Medicine ER -