A lot has happened since starting this blog and as such I
have decided to explain everything in two parts. A few weeks ago I attended a
Cancer epidemiology Journal Club that reviewed the following research paper and
a corresponding newspaper article. The paper entitled, Incidence of Breast Cancer With Distant Involvement Among Women in the
United States, 1976 to 2009 by R.H. Johnson, F.L. Chien, and A.B. Bleyer
published in February 2013 and its newspaper review Advanced cancer in Young Women by Judy Peres reported that their
was an increase in breast cancer incidence in women 25- to 39- years of age.
This was based on data collected from SEER 9, SEER 13, and SEER 18, which
represent 9.5%, 15%, and 28% of the US population since 1975, 1992, and 2009, respectively.
For the most part, incidence rates for localized and regional breast cancers
amongst all age groups, young and old, remained constant across the decades.
However, in women diagnosed with breast cancers found in distal regions from
the primary site, incidence has nearly from 1.53 per 100,000 in 1976 to 2.90
per 100,000 in 2009. In the 25- to 39- year old age group it was also reported
that women with tumors that that women with ER+/PR- status (estrogen and
progesterone receptor status) displayed a higher annual percent change (8.89)
when compared with women with ER+/PR+ status (8.15), women with ER-/PR- status
(5.44), and ER-/PR+ status (-0.51).
The paper raised some healthy discussion in the group. The
debate included possible exposure and risk factors that people in the community
may have encountered. They then went on to offer evidence of whether their
proposed factors matched up with the timeline of disease. In addition, errors
in the analysis of the data were discussed. Suggestions included:
misidentification of a tumor’s primary site in older records, changing
standards in stage classification, and the risk of drawing such damning
conclusions when dealing with such a small sample size of young women with
breast cancer.
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