caa a22 4500 39756144X CHVBK 20180308164817.0 cr unu---uuuuu 161202e19961106xx s 000 0 eng 10.1093/jnci/88.21.1571 doi (NATIONALLICENCE)oxford-10.1093/jnci/88.21.1571 Recent Trends in U.S. Breast Cancer Incidence, Survival, and Mortality Rates [Elektronische Daten] [Kenneth C. Chu, Robert E. Tarone, Larry G. Kessler, Lynn A. G. Ries, Benjamin F. Hankey, Barry A. Miller, Brenda K. Edwards] Background: Clinical trials have demonstrated that use of mammographic screening and advances in therapy can improve prognosis for women with breast cancer. Purpose: We determined the trends in breast cancer mortality rates, as well as incidence and survival rates by extent of disease at diagnosis, for white women in the United States and considered whether these trends are consistent with widespread use of such beneficial medical interventions. Methods: We examined mortality data from the National Center for Health Statistics and incidence and survival data by extent of disease from the Surveillance, Epidemiology, and End Results Program of the National Cancer Institute, all stratified by patient age, using statistical-regression techniques to determine changes in the slope of trends over time. Results: The age-adjusted breast cancer mortality rate for U.S. white females dropped 6.8% from 1989 through 1993. A significant decrease in the slope of the mortality trend of approximately 2% per year was observed in every decade of age from 40 to 79 years of age. Trends in incidence rates were also similar among these age groups: localized disease rates increased rapidly from 1982 through 1987 and stabilized or increased more slowly thereafter; regional disease rates decreased after 1987; and distant disease rates have remained level over the past 20 years. Three-year relative survival rates increased steadily and significantly for both localized and regional disease from 1980 through 1989 in all ages, with no evidence of an increase in slope in the late 1980s. Implications: The decrease in the diagnosis of regional disease in the late 1980s in women over the age of 40 years likely reflects the increased use of mammography earlier in the 1980s. The increase in survival rates, particularly for regional disease, likely reflects improvements in systemic adjuvant therapy. Statistical modeling indicates that the recent drop in breast cancer mortality is too rapid to be explained only by the increased use of mammography; likewise, there has been no equivalent dramatic increase in survival rates that would implicate therapy alone. Thus, indications are that both are involved in the recent rapid decline in breast cancer mortality rates in the United States. [J Natl Cancer Inst 1996;88:1571-9] © Oxford University Press ARTICLES nationallicence Chu Kenneth C. Special Population Studies Branch, Division of Cancer Prevention and Control aut Tarone Robert E. Biostatistics Branch, Division of Epidemiology and Genetics, National Cancer Institute Bethesda, MD aut Kessler Larry G. Applied Research Branch, Division of Cancer Prevention and Control aut Ries Lynn A. G. Cancer Statistics Branch, Division of Cancer Prevention and Control aut Hankey Benjamin F. Cancer Statistics Branch, Division of Cancer Prevention and Control aut Miller Barry A. Cancer Statistics Branch, Division of Cancer Prevention and Control aut Edwards Brenda K. Cancer Control Research Program, Division of Cancer Prevention and Control aut JNCI: Journal of the National Cancer Institute Oxford University Press 88/21(1996-11-06), 1571-1579 0027-8874 88:21<1571 1996 88 jnci https://doi.org/10.1093/jnci/88.21.1571 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1093/jnci/88.21.1571 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Chu Kenneth C. Special Population Studies Branch, Division of Cancer Prevention and Control aut NATIONALLICENCE 700 1- Tarone Robert E. Biostatistics Branch, Division of Epidemiology and Genetics, National Cancer Institute Bethesda, MD aut NATIONALLICENCE 700 1- Kessler Larry G. Applied Research Branch, Division of Cancer Prevention and Control aut NATIONALLICENCE 700 1- Ries Lynn A. G. Cancer Statistics Branch, Division of Cancer Prevention and Control aut NATIONALLICENCE 700 1- Hankey Benjamin F. Cancer Statistics Branch, Division of Cancer Prevention and Control aut NATIONALLICENCE 700 1- Miller Barry A. Cancer Statistics Branch, Division of Cancer Prevention and Control aut NATIONALLICENCE 700 1- Edwards Brenda K. Cancer Control Research Program, Division of Cancer Prevention and Control aut NATIONALLICENCE 773 0- JNCI: Journal of the National Cancer Institute Oxford University Press 88/21(1996-11-06), 1571-1579 0027-8874 88:21<1571 1996 88 jnci Metadata rights reserved CC BY-NC-4.0 http://creativecommons.org/licenses/by-nc/4.0 nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-oxford