Comparison of the ductal carcinoma in situ between White Americans and Chinese Americans

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Abstract

Currently, the wide-spread use of screening mammography has led to dramatic increases in ductal carcinoma in situ (DCIS). However, DCIS of Chinese Americans, the largest Asian subgroup in American, has rarely been comprehensively studied over the past decade. This work compared the DCIS characteristics and prognosis of Chinese American patients with White Americans in the USA to determine the characteristics and prognosis of DCIS patients of Chinese Americans.

The data were obtained using the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) data. The diagnosis and treatment variables between the two groups were compared by means of Chi-square tests. Survival was determined with the use of the Kaplan–Meier method and the multivariable Cox proportional hazard regression model.

From 1975 to 2016, 81,745 White Americans and 2069 Chinese Americans were diagnosed with ductal carcinoma in situ. Compared with the white patients, the Chinese Americans were younger ( P < .001) with smaller tumors ( P < .001) and higher family income ( P < .001). DCIS patients of Chinese American group accounted for a higher percentage of all breast cancers than the whites ( P < .001). In the multivariable Cox proportional hazard regression analysis, Chinese American was an independent favorable prognostic factor in terms of overall survival (OS) (HR, 0.684; 95% CI, 0.593–0.789; P < .001) compared with the white group.

In conclusion, DCIS characteristics of the Chinese group, which exhibited a higher proportion of younger age, a higher DCIS ratio, and a better prognosis, were distinct from those of the White Americans.

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Most cited references 49

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Cancer statistics, 2019

Rebecca Siegel, Kimberly D Miller, Ahmedin Jemal (2019)

Each year, the American Cancer Society estimates the numbers of new cancer cases and deaths that will occur in the United States and compiles the most recent data on cancer incidence, mortality, and survival. Incidence data, available through 2015, were collected by the Surveillance, Epidemiology, and End Results Program; the National Program of Cancer Registries; and the North American Association of Central Cancer Registries. Mortality data, available through 2016, were collected by the National Center for Health Statistics. In 2019, 1,762,450 new cancer cases and 606,880 cancer deaths are projected to occur in the United States. Over the past decade of data, the cancer incidence rate (2006-2015) was stable in women and declined by approximately 2% per year in men, whereas the cancer death rate (2007-2016) declined annually by 1.4% and 1.8%, respectively. The overall cancer death rate dropped continuously from 1991 to 2016 by a total of 27%, translating into approximately 2,629,200 fewer cancer deaths than would have been expected if death rates had remained at their peak. Although the racial gap in cancer mortality is slowly narrowing, socioeconomic inequalities are widening, with the most notable gaps for the most preventable cancers. For example, compared with the most affluent counties, mortality rates in the poorest counties were 2-fold higher for cervical cancer and 40% higher for male lung and liver cancers during 2012-2016. Some states are home to both the wealthiest and the poorest counties, suggesting the opportunity for more equitable dissemination of effective cancer prevention, early detection, and treatment strategies. A broader application of existing cancer control knowledge with an emphasis on disadvantaged groups would undoubtedly accelerate progress against cancer.

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Cancer statistics in China, 2015.

Wanqing Chen, Rongshou Zheng, Peter D Baade … (2016)

With increasing incidence and mortality, cancer is the leading cause of death in China and is a major public health problem. Because of China's massive population (1.37 billion), previous national incidence and mortality estimates have been limited to small samples of the population using data from the 1990s or based on a specific year. With high-quality data from an additional number of population-based registries now available through the National Central Cancer Registry of China, the authors analyzed data from 72 local, population-based cancer registries (2009-2011), representing 6.5% of the population, to estimate the number of new cases and cancer deaths for 2015. Data from 22 registries were used for trend analyses (2000-2011). The results indicated that an estimated 4292,000 new cancer cases and 2814,000 cancer deaths would occur in China in 2015, with lung cancer being the most common incident cancer and the leading cause of cancer death. Stomach, esophageal, and liver cancers were also commonly diagnosed and were identified as leading causes of cancer death. Residents of rural areas had significantly higher age-standardized (Segi population) incidence and mortality rates for all cancers combined than urban residents (213.6 per 100,000 vs 191.5 per 100,000 for incidence; 149.0 per 100,000 vs 109.5 per 100,000 for mortality, respectively). For all cancers combined, the incidence rates were stable during 2000 through 2011 for males (+0.2% per year; P = .1), whereas they increased significantly (+2.2% per year; P < .05) among females. In contrast, the mortality rates since 2006 have decreased significantly for both males (-1.4% per year; P < .05) and females (-1.1% per year; P < .05). Many of the estimated cancer cases and deaths can be prevented through reducing the prevalence of risk factors, while increasing the effectiveness of clinical care delivery, particularly for those living in rural areas and in disadvantaged populations.

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Cancer statistics, 2018

Kimberly D Miller, Rebecca Siegel, Ahmedin Jemal (2018)

Each year, the American Cancer Society estimates the numbers of new cancer cases and deaths that will occur in the United States and compiles the most recent data on cancer incidence, mortality, and survival. Incidence data, available through 2014, were collected by the Surveillance, Epidemiology, and End Results Program; the National Program of Cancer Registries; and the North American Association of Central Cancer Registries. Mortality data, available through 2015, were collected by the National Center for Health Statistics. In 2018, 1,735,350 new cancer cases and 609,640 cancer deaths are projected to occur in the United States. Over the past decade of data, the cancer incidence rate (2005-2014) was stable in women and declined by approximately 2% annually in men, while the cancer death rate (2006-2015) declined by about 1.5% annually in both men and women. The combined cancer death rate dropped continuously from 1991 to 2015 by a total of 26%, translating to approximately 2,378,600 fewer cancer deaths than would have been expected if death rates had remained at their peak. Of the 10 leading causes of death, only cancer declined from 2014 to 2015. In 2015, the cancer death rate was 14% higher in non-Hispanic blacks (NHBs) than non-Hispanic whites (NHWs) overall (death rate ratio [DRR], 1.14; 95% confidence interval [95% CI], 1.13-1.15), but the racial disparity was much larger for individuals aged <65 years (DRR, 1.31; 95% CI, 1.29-1.32) compared with those aged ≥65 years (DRR, 1.07; 95% CI, 1.06-1.09) and varied substantially by state. For example, the cancer death rate was lower in NHBs than NHWs in Massachusetts for all ages and in New York for individuals aged ≥65 years, whereas for those aged <65 years, it was 3 times higher in NHBs in the District of Columbia (DRR, 2.89; 95% CI, 2.16-3.91) and about 50% higher in Wisconsin (DRR, 1.78; 95% CI, 1.56-2.02), Kansas (DRR, 1.51; 95% CI, 1.25-1.81), Louisiana (DRR, 1.49; 95% CI, 1.38-1.60), Illinois (DRR, 1.48; 95% CI, 1.39-1.57), and California (DRR, 1.45; 95% CI, 1.38-1.54). Larger racial inequalities in young and middle-aged adults probably partly reflect less access to high-quality health care. CA Cancer J Clin 2018;68:7-30. © 2018 American Cancer Society.

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Author and article information

Journal

Journal ID (nlm-ta): Medicine (Baltimore)

Journal ID (iso-abbrev): Medicine (Baltimore)

Journal ID (publisher-id): MEDI

Title: Medicine

Publisher: Lippincott Williams & Wilkins (Hagerstown, MD )

ISSN (Print): 0025-7974

ISSN (Electronic): 1536-5964

Publication date Collection: 22 January 2021

Publication date (Electronic): 22 January 2021

Volume: 100

Issue: 3

Electronic Location Identifier: e24136

Affiliations

[a ]Department of Breast and Thyroid Surgery

[b ]Department of Plastic Surgery, Renmin Hospital of Wuhan University, Wuhan, Hubei, P.R. China.

Author notes

[∗ ]Correspondence: Chuang Chen, Department of Breast and Thyroid Surgery (e-mail: chenc2469@ 123456163.com ); Zhanyong Zhu, Department of Plastic Surgery, Renmin Hospital of Wuhan University, No 238 Jiefang Road, Wuchang District, Wuhan, Hubei 430060, P.R. China (e-mail: zyzhu@ 123456whu.edu.cn ).

Article

Publisher ID: MD-D-20-05288 Accession ID: 24136

DOI: 10.1097/MD.0000000000024136

PMC ID: 7837883

SO-VID: e8f667ff-e581-47c0-b6eb-f7208bd0b929

License:

This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial License 4.0 (CCBY-NC), where it is permissible to download, share, remix, transform, and buildup the work provided it is properly cited. The work cannot be used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc/4.0

History

Date received : 2 June 2020

Date revision received : 29 October 2020

Date accepted : 8 December 2020

Funding

Funded by: Fundamental Research Funds for the Central Universities

Award ID: 2042019kf0229

Award Recipient : Chuang Chen

Funded by: National Key Scientific Instrument and Equipment Development Projects of China

Award ID: 20133655893

Award Recipient : Chuang Chen

Funded by: Natural Science Foundation of Hubei Province

Award ID: 2016CFB331

Award Recipient : Chuang Chen

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Keywords: breast cancer,breast-conserving therapy,chinese americans,ductal carcinoma in situ,epidemiology and end results (seer) database,surveillance,white americans

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Keywords: breast cancer, breast-conserving therapy, chinese americans, ductal carcinoma in situ, epidemiology and end results (seer) database, surveillance, white americans

Comparison of the ductal carcinoma in situ between White Americans and Chinese Americans

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Most cited references 49

Cancer statistics, 2019

Cancer statistics in China, 2015.

Cancer statistics, 2018

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