Changes in the pattern of breast cancer burden among African American women: evidence based on 29 states and District of Columbia during 1998 to 2010

Abstract Purpose Assessment of breast cancer (BC) pattern in individual states with respect to ethnicity. Methods Population-based cancer registries from the Cancer Incidence in Five Continents databases (1998–2007) supplemented with Surveillance, Epidemiology, and End Results data from 2008 to 2010 were used. Results The age-specific burden showed a clear convergence of BC burden among African American (AA) and Caucasian American (CA) in most states. This was primarily because of a decrease in the BC rate among CA aged 50 years or older and an increase among AA of the same age group. The 2003–2007/1998–2002 rate ratio for CA was 0.91 (95% confidence interval [CI], 0.90–0.91) in the South, whereas it was 1.06 (95% CI, 1.04–1.08) for AA. This convergence was confirmed in states with available data for the period 2008 to 2010. The AA/CA rate ratio among women aged younger than 40 years was 0.99 (95% CI, 0.99–1.04) in the Northeast, 1.29 (95% CI, 1.25–1.33) in the South, and 1.10 (95% CI, 1.04–1.17) in the West. This pattern correlates with the estrogen receptor positive and progesterone receptor positive pattern. The strongest disparity in estrogen receptor negative was observed in Louisiana which with Detroit, have had the highest rates of estrogen receptor negative. Conclusions The changes in postmenopausal hormone use and mammography screening might have played a role in the observed convergence.