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Early- and Late-Onset Breast Cancer Types Among Women in the United States and Japan

¹ Biostatistics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Rockville, Maryland; ² Statistics and Cancer Control Division, Research Center for Cancer Prevention and Screening, National Cancer Center; ³ Department of Cancer Control and Statistics, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan; ⁴ Oncology Early Clinical Development, Novartis Pharma KK, Tokyo, Japan; and ⁵ Department of Epidemiology and Biostatistics, George Washington University, Washington, District of Columbia

Requests for reprints: Rayna K. Matsuno, Biostatistics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, 6120 Executive Boulevard, Room 8105, Rockville, MD 20852-7244. Phone: 301-451-6889; Fax: 301-402-0081. E-mail: matsunora{at}mail.nih.gov

Background: Although differences in breast cancer incidence among Occidental and Asian populations are often attributed to variations in environmental exposures and/or lifestyle, fewer studies have systematically examined the effect of age-related variations.

Methods: To further explore age-related geographic breast cancer variations, we compared age-specific incidence patterns among cases of female invasive breast cancer from the Surveillance, Epidemiology, and End Results (SEER) program and the Osaka Cancer Registry (1978-1997).

Results: In SEER, there were 236,130 Whites, 21,137 Blacks, and 3,304 Japanese-Americans in Hawaii with invasive breast cancer. In Osaka, there were 25,350 cases. Incidence rates per 100,000 woman-years ranged from 87.6 among Whites to 21.8 in Osaka. Age-specific incidence rates increased rapidly until age 50 years for all race/ethnicity groups, and then continued to increase more slowly for Whites, Blacks, and Japanese-Americans in Hawaii but plateaud for Osaka. Age-specific incidence rates in SEER reflected bimodal (early-onset and late-onset) breast cancer populations, whereas Osaka had only an early-onset age distribution. These age-specific differences in incidence among SEER and Osaka persisted after adjustment for calendar-period and birth-cohort effects using age-period-cohort models.

Conclusions: Results confirm striking age-specific differences among Occidental and native Japanese breast cancer populations, probably due to complex age-related biological and/or environmental variations among Occidental and Asian breast cancer populations. (Cancer Epidemiol Biomarkers Prev 2007;16(7):1437–42)

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