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Wang F, Tse LA, Chan WC, Kwok CCH, Leung SL, Wu C, Mang OWK, Ngan RKC, Li M, Yu WC, Tsang KH, Law SH, Miao X, Wu C, Zheng Y, Wu F, Yang XR, Yu ITS. Disparities of time trends and birth cohort effects on invasive breast cancer incidence in Shanghai and Hong Kong pre- and post-menopausal women. BMC Cancer 2017; 17:362. [PMID: 28535760 PMCID: PMC5442698 DOI: 10.1186/s12885-017-3359-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2015] [Accepted: 05/15/2017] [Indexed: 12/29/2022] Open
Abstract
Background Breast cancer is the leading cause of cancer morbidity among Shanghai and Hong Kong women, which contributes to 20–25% of new female cancer incidents. This study aimed to describe the temporal trend of breast cancer and interpret the potential effects on the observed secular trends. Methods Cancer incident data were obtained from the cancer registries. Age-standardized incidence rate was computed by the direct method using the World population of 2000. Average annual percentage change (AAPC) in incidence rate was estimated by the Joinpoint regression. Age, period and cohort effects were assessed by using a log-linear model with Poisson regression. Results During 1976–2009, an increasing trend of breast cancer incidence was observed, with an AAPC of 1.73 [95% confidence interval (CI): 1.54–1.92)] for women in Hong Kong and 2.83 (95% CI, 2.26–3.40) in Shanghai. Greater upward trends were revealed in Shanghai women aged 50 years old or above (AAPC = 3.09; 95% CI, 1.48–4.73). Using age at 50 years old as cut-point, strong birth cohort effects were shown in both pre- and post-menopausal women, though a more remarkable effect was suggested in Shanghai post-menopausal women. No evidence for a period effect was indicated. Conclusions Incidence rate of breast cancer has been more speedy in Shanghai post-menopausal women than that of the Hong Kong women over the past 30 years. Decreased birth rate and increasing environmental exposures (e.g., light-at-night) over successive generations may have constituted major impacts on the birth cohort effects, especially for the post-menopausal breast cancer; further analytic studies are warranted. Electronic supplementary material The online version of this article (doi:10.1186/s12885-017-3359-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Feng Wang
- JC School of Public Health and Primary Care, the Chinese University of Hong Kong, Sha Tin, Hong Kong SAR, China
| | - Lap Ah Tse
- JC School of Public Health and Primary Care, the Chinese University of Hong Kong, Sha Tin, Hong Kong SAR, China.
| | - Wing-Cheong Chan
- Department of Surgery, North District Hospital, Sheung Shui, Hong Kong SAR, China
| | - Carol Chi-Hei Kwok
- Department of Oncology, Princess Margaret Hospital, Kwai Chung, Hong Kong SAR, China
| | - Siu-Lan Leung
- Department of Surgery, Pamela Youde Nethersole Eastern Hospital, Chai Wan, Hong Kong SAR, China
| | - Cherry Wu
- Department of Pathology, North District Hospital, Sheung Shui, Hong Kong SAR, China
| | - Oscar Wai-Kong Mang
- Hong Kong Cancer Registry, Hospital Authority, Yau Ma Tei, Hong Kong SAR, China
| | | | - Mengjie Li
- JC School of Public Health and Primary Care, the Chinese University of Hong Kong, Sha Tin, Hong Kong SAR, China
| | - Wai-Cho Yu
- Department of Medicine and Geriatrics, Princess Margaret Hospital, Kwai Chung, Hong Kong SAR, China
| | - Koon-Ho Tsang
- Department of Pathology, Yan Chai Hospital, Tsuen Wan, Hong Kong SAR, China
| | - Sze-Hong Law
- Department of Surgery, Yan Chai Hospital, Tsuen Wan, Hong Kong SAR, China
| | - Xiaoping Miao
- Department of Epidemiology and Biostatistics, Tongji School of Public Health, Huazhong University of Science and Technology, Wuhan, China
| | - Chunxiao Wu
- Shanghai Municipal Center for Disease Control & Prevention, Shanghai, China
| | - Ying Zheng
- Shanghai Municipal Center for Disease Control & Prevention, Shanghai, China
| | - Fan Wu
- Shanghai Municipal Center for Disease Control & Prevention, Shanghai, China
| | - Xiaohong R Yang
- Genetic Epidemiology Branch, Division of Cancer Epidemiology & Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Ignatius Tak-Sun Yu
- JC School of Public Health and Primary Care, the Chinese University of Hong Kong, Sha Tin, Hong Kong SAR, China
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Sung H, Rosenberg PS, Chen WQ, Hartman M, Lim WY, Chia KS, Wai-Kong Mang O, Chiang CJ, Kang D, Ngan RKC, Tse LA, Anderson WF, Yang XR. Female breast cancer incidence among Asian and Western populations: more similar than expected. J Natl Cancer Inst 2015; 107:djv107. [PMID: 25868578 DOI: 10.1093/jnci/djv107] [Citation(s) in RCA: 112] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Previous reports suggested that female breast cancer is associated with earlier ages at onset among Asian than Western populations. However, most studies utilized cross-sectional analyses that may be confounded by calendar-period and/or birth cohort effects. We, therefore, considered a longitudinal (forward-looking) approach adjusted for calendar-period changes and conditioned upon birth cohort. METHODS Invasive female breast cancer data (1988-2009) were obtained from cancer registries in China, Hong Kong, South Korea, Taiwan, Singapore, and the United States. Age-period-cohort models were used to extrapolate longitudinal age-specific incidence rates for the 1920, 1944, and 1970 birth cohorts. RESULTS Cross-sectional age-specific incidence rates rose continuously until age 80 years among US white women, but plateaued or decreased after age 50 years among Asian women. In contrast, longitudinal age-specific rates were proportional (similar) among all Asian countries and the United States with incidence rates rising continuously until age 80 years. The extrapolated estimates for the most recent cohorts in some Asian countries actually showed later ages at onset than in the United States. Additionally, over successive birth cohorts, the incidence rate ratios (IRRs) for the longitudinal curves converged (narrowed) between Asian and US white women. CONCLUSIONS Similar longitudinal age-specific incidence rates along with converging IRRs indicate that the age effects for invasive breast cancer are more similar among Asian and Western populations than might be expected from a solely cross-sectional analysis. Indeed, the Asian breast cancer rates in recent generations are even surpassing the historically high rates in the United States, highlighting an urgent need for efficient prevention and treatment strategies among Asian populations.
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Affiliation(s)
- Hyuna Sung
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD (HS, PSR, WFA, XRY); National Office for Cancer Prevention and Control & National Central Cancer Registry, National Cancer Center, Beijing, China (WQC); Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden (MH); Saw Swee Hock School of Public Health, National University of Singapore, Singapore (MH, WYL, KSC); Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore (MH); Hong Kong Cancer Registry, Hospital Authority, Hong Kong, China (OWKM, RKCN); Taiwan Cancer Registry and Graduate Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan (CJC); Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea (DK); Department of Clinical Oncology, Queen Elizabeth Hospital, Kowloon, Hong Kong, China (RKCN); Division of Occupational and Environmental Health, JC School of Public Health and Primary Care, the Chinese University of Hong Kong, Hong Kong, China (LAT).
| | - Philip S Rosenberg
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD (HS, PSR, WFA, XRY); National Office for Cancer Prevention and Control & National Central Cancer Registry, National Cancer Center, Beijing, China (WQC); Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden (MH); Saw Swee Hock School of Public Health, National University of Singapore, Singapore (MH, WYL, KSC); Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore (MH); Hong Kong Cancer Registry, Hospital Authority, Hong Kong, China (OWKM, RKCN); Taiwan Cancer Registry and Graduate Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan (CJC); Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea (DK); Department of Clinical Oncology, Queen Elizabeth Hospital, Kowloon, Hong Kong, China (RKCN); Division of Occupational and Environmental Health, JC School of Public Health and Primary Care, the Chinese University of Hong Kong, Hong Kong, China (LAT)
| | - Wan-Qing Chen
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD (HS, PSR, WFA, XRY); National Office for Cancer Prevention and Control & National Central Cancer Registry, National Cancer Center, Beijing, China (WQC); Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden (MH); Saw Swee Hock School of Public Health, National University of Singapore, Singapore (MH, WYL, KSC); Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore (MH); Hong Kong Cancer Registry, Hospital Authority, Hong Kong, China (OWKM, RKCN); Taiwan Cancer Registry and Graduate Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan (CJC); Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea (DK); Department of Clinical Oncology, Queen Elizabeth Hospital, Kowloon, Hong Kong, China (RKCN); Division of Occupational and Environmental Health, JC School of Public Health and Primary Care, the Chinese University of Hong Kong, Hong Kong, China (LAT)
| | - Mikael Hartman
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD (HS, PSR, WFA, XRY); National Office for Cancer Prevention and Control & National Central Cancer Registry, National Cancer Center, Beijing, China (WQC); Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden (MH); Saw Swee Hock School of Public Health, National University of Singapore, Singapore (MH, WYL, KSC); Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore (MH); Hong Kong Cancer Registry, Hospital Authority, Hong Kong, China (OWKM, RKCN); Taiwan Cancer Registry and Graduate Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan (CJC); Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea (DK); Department of Clinical Oncology, Queen Elizabeth Hospital, Kowloon, Hong Kong, China (RKCN); Division of Occupational and Environmental Health, JC School of Public Health and Primary Care, the Chinese University of Hong Kong, Hong Kong, China (LAT)
| | - Wei-Yen Lim
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD (HS, PSR, WFA, XRY); National Office for Cancer Prevention and Control & National Central Cancer Registry, National Cancer Center, Beijing, China (WQC); Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden (MH); Saw Swee Hock School of Public Health, National University of Singapore, Singapore (MH, WYL, KSC); Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore (MH); Hong Kong Cancer Registry, Hospital Authority, Hong Kong, China (OWKM, RKCN); Taiwan Cancer Registry and Graduate Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan (CJC); Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea (DK); Department of Clinical Oncology, Queen Elizabeth Hospital, Kowloon, Hong Kong, China (RKCN); Division of Occupational and Environmental Health, JC School of Public Health and Primary Care, the Chinese University of Hong Kong, Hong Kong, China (LAT)
| | - Kee Seng Chia
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD (HS, PSR, WFA, XRY); National Office for Cancer Prevention and Control & National Central Cancer Registry, National Cancer Center, Beijing, China (WQC); Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden (MH); Saw Swee Hock School of Public Health, National University of Singapore, Singapore (MH, WYL, KSC); Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore (MH); Hong Kong Cancer Registry, Hospital Authority, Hong Kong, China (OWKM, RKCN); Taiwan Cancer Registry and Graduate Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan (CJC); Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea (DK); Department of Clinical Oncology, Queen Elizabeth Hospital, Kowloon, Hong Kong, China (RKCN); Division of Occupational and Environmental Health, JC School of Public Health and Primary Care, the Chinese University of Hong Kong, Hong Kong, China (LAT)
| | - Oscar Wai-Kong Mang
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD (HS, PSR, WFA, XRY); National Office for Cancer Prevention and Control & National Central Cancer Registry, National Cancer Center, Beijing, China (WQC); Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden (MH); Saw Swee Hock School of Public Health, National University of Singapore, Singapore (MH, WYL, KSC); Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore (MH); Hong Kong Cancer Registry, Hospital Authority, Hong Kong, China (OWKM, RKCN); Taiwan Cancer Registry and Graduate Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan (CJC); Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea (DK); Department of Clinical Oncology, Queen Elizabeth Hospital, Kowloon, Hong Kong, China (RKCN); Division of Occupational and Environmental Health, JC School of Public Health and Primary Care, the Chinese University of Hong Kong, Hong Kong, China (LAT)
| | - Chun-Ju Chiang
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD (HS, PSR, WFA, XRY); National Office for Cancer Prevention and Control & National Central Cancer Registry, National Cancer Center, Beijing, China (WQC); Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden (MH); Saw Swee Hock School of Public Health, National University of Singapore, Singapore (MH, WYL, KSC); Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore (MH); Hong Kong Cancer Registry, Hospital Authority, Hong Kong, China (OWKM, RKCN); Taiwan Cancer Registry and Graduate Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan (CJC); Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea (DK); Department of Clinical Oncology, Queen Elizabeth Hospital, Kowloon, Hong Kong, China (RKCN); Division of Occupational and Environmental Health, JC School of Public Health and Primary Care, the Chinese University of Hong Kong, Hong Kong, China (LAT)
| | - Daehee Kang
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD (HS, PSR, WFA, XRY); National Office for Cancer Prevention and Control & National Central Cancer Registry, National Cancer Center, Beijing, China (WQC); Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden (MH); Saw Swee Hock School of Public Health, National University of Singapore, Singapore (MH, WYL, KSC); Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore (MH); Hong Kong Cancer Registry, Hospital Authority, Hong Kong, China (OWKM, RKCN); Taiwan Cancer Registry and Graduate Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan (CJC); Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea (DK); Department of Clinical Oncology, Queen Elizabeth Hospital, Kowloon, Hong Kong, China (RKCN); Division of Occupational and Environmental Health, JC School of Public Health and Primary Care, the Chinese University of Hong Kong, Hong Kong, China (LAT)
| | - Roger Kai-Cheong Ngan
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD (HS, PSR, WFA, XRY); National Office for Cancer Prevention and Control & National Central Cancer Registry, National Cancer Center, Beijing, China (WQC); Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden (MH); Saw Swee Hock School of Public Health, National University of Singapore, Singapore (MH, WYL, KSC); Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore (MH); Hong Kong Cancer Registry, Hospital Authority, Hong Kong, China (OWKM, RKCN); Taiwan Cancer Registry and Graduate Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan (CJC); Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea (DK); Department of Clinical Oncology, Queen Elizabeth Hospital, Kowloon, Hong Kong, China (RKCN); Division of Occupational and Environmental Health, JC School of Public Health and Primary Care, the Chinese University of Hong Kong, Hong Kong, China (LAT)
| | - Lap Ah Tse
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD (HS, PSR, WFA, XRY); National Office for Cancer Prevention and Control & National Central Cancer Registry, National Cancer Center, Beijing, China (WQC); Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden (MH); Saw Swee Hock School of Public Health, National University of Singapore, Singapore (MH, WYL, KSC); Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore (MH); Hong Kong Cancer Registry, Hospital Authority, Hong Kong, China (OWKM, RKCN); Taiwan Cancer Registry and Graduate Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan (CJC); Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea (DK); Department of Clinical Oncology, Queen Elizabeth Hospital, Kowloon, Hong Kong, China (RKCN); Division of Occupational and Environmental Health, JC School of Public Health and Primary Care, the Chinese University of Hong Kong, Hong Kong, China (LAT)
| | - William F Anderson
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD (HS, PSR, WFA, XRY); National Office for Cancer Prevention and Control & National Central Cancer Registry, National Cancer Center, Beijing, China (WQC); Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden (MH); Saw Swee Hock School of Public Health, National University of Singapore, Singapore (MH, WYL, KSC); Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore (MH); Hong Kong Cancer Registry, Hospital Authority, Hong Kong, China (OWKM, RKCN); Taiwan Cancer Registry and Graduate Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan (CJC); Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea (DK); Department of Clinical Oncology, Queen Elizabeth Hospital, Kowloon, Hong Kong, China (RKCN); Division of Occupational and Environmental Health, JC School of Public Health and Primary Care, the Chinese University of Hong Kong, Hong Kong, China (LAT)
| | - Xiaohong R Yang
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD (HS, PSR, WFA, XRY); National Office for Cancer Prevention and Control & National Central Cancer Registry, National Cancer Center, Beijing, China (WQC); Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden (MH); Saw Swee Hock School of Public Health, National University of Singapore, Singapore (MH, WYL, KSC); Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore (MH); Hong Kong Cancer Registry, Hospital Authority, Hong Kong, China (OWKM, RKCN); Taiwan Cancer Registry and Graduate Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan (CJC); Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea (DK); Department of Clinical Oncology, Queen Elizabeth Hospital, Kowloon, Hong Kong, China (RKCN); Division of Occupational and Environmental Health, JC School of Public Health and Primary Care, the Chinese University of Hong Kong, Hong Kong, China (LAT)
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