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Cancer Epidemiology, Biomarkers & Prevention
Cancer Epidemiology, Biomarkers & Prevention
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Incidence of Ductal Carcinoma In Situ in the United States, 2000–2014

Marc D. Ryser, Laura H. Hendrix, Mathias Worni, Yiling Liu, Terry Hyslop and E. Shelley Hwang
Marc D. Ryser
1Department of Population Health Sciences, Duke University Medical Center, Durham, North Carolina.
2Department of Mathematics, Duke University, Durham, North Carolina.
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  • For correspondence: marc.ryser@duke.edu
Laura H. Hendrix
3Department of Biostatistics & Bioinformatics, Duke University Medical Center, Durham, North Carolina.
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Mathias Worni
4Department of Visceral Surgery and Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
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Yiling Liu
5Duke Center for Applied Genomics & Precision Medicine, Duke University Medical Center, Durham, North Carolina.
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Terry Hyslop
3Department of Biostatistics & Bioinformatics, Duke University Medical Center, Durham, North Carolina.
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E. Shelley Hwang
6Department of Surgery, Division of Advanced Oncologic and GI Surgery, Duke University Medical Center, Durham, North Carolina.
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DOI: 10.1158/1055-9965.EPI-18-1262 Published August 2019
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  • Figure 1.
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    Figure 1.

    Age-adjusted DCIS incidence trends, overall and by age and race. APC in the DCIS incidence rate in the United States, 2000–2014, overall (A), age group (B), and by race (C). Asterisk (*) indicates that the APC is statistically significantly different from zero (P < 0.05). To highlight trends, the scales of the y-axes vary.

  • Figure 2.
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    Figure 2.

    Trends in tumor characteristics among women diagnosed with DCIS. Proportions of women diagnosed with ER-positive and PR-positive DCIS (A), grade I, II, and III DCIS (B), and small (1–10 mm), intermediate (11–30 mm), and large (>30 mm) DCIS (C) in the United States, 2000–2014. Only cases with known tumor features are included in the analyses.

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    Figure 3.

    Trends in tumor characteristics among women diagnosed with DCIS; subgroup analyses. Proportions of women diagnosed with ER-positive and progesterone (PR)-positive DCIS, grade I, II, and III DCIS, and small (1–10 mm), intermediate (11–30 mm), large (>30 mm) DCIS among white women (A) and black women (B), in the United States, 2000–2014. Only cases with known tumor features are included in the analyses.

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    Figure 4.

    Mammogram utilization (1987–2015) and DCIS incidence (1992–2014), by age groups and race. Crude mammogram utilization (NIHS data) and DCIS incidence (SEER 13) rates among women of all races ages 40–49 years (A), 50–64 years (B), and greater than 65 years (C), and for all ages by race (D). Scales for DCIS incidence and mammogram utilization on the left and right sides of the graphs, respectively.

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    Figure 5.

    Incidence and mortality rates of female breast, cervical, and colorectal (male and female) cancers in the United States, 1999–2015. Relative rates are obtained by rescaling the actual rates with respect to the baseline rates in 1999. Data extracted from the U.S. Cancer Statistics Data Visualizations Tool (12).

Tables

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  • Table 1.

    Trends in patient and tumor features

    Total (N = 145,670)2000–03 (N = 34,554)2004–07 (N = 37,188)2008–11 (N = 41,783)2012–2014 (N = 32,145)
    n (%)n (%)n (%)n (%)n (%)Pa
    Age<0.001
     20–44 years17,860 (12.3)4,503 (13)4,725 (12.7)4,999 (12)3,633 (11.3)
     45–54 years40,512 (27.8)9,534 (27.6)10,710 (28.8)11,767 (28.2)8,501 (26.4)
     55–69 years56,512 (38.8)12,510 (36.2)13,782 (37.1)16,554 (39.6)13,666 (42.5)
     ≥70 years30,786 (21.1)8,007 (23.2)7,971 (21.4)8,463 (20.3)6,345 (19.7)
    Race<0.001
     White113,396 (77.8)28,125 (81.4)29,440 (79.2)32,084 (76.8)23,747 (73.9)
     Black15,712 (10.8)3,222 (9.3)3,897 (10.5)4,647 (11.1)3,946 (12.3)
     Other15,112 (10.4)2,978 (8.6)3,561 (9.5)4,609 (11.0)3,964 (12.0)
     Unknown1,450 (1.0)229 (0.7)290 (0.8)443 (1.1)488 (1.5)
    ER status<0.001
     Positive83,168 (57.1)4,857 (14.1)21,276 (57.2)30,865 (73.9)26,170 (81.4)
     Negative14,592 (10.0)1,198 (3.5)4,521 (12.2)5,125 (12.3)3,748 (11.7)
     Unknown47,910 (32.9)28,499 (82.5)11,391 (30.6)5,793 (13.9)2,227 (6.9)
    PR status<0.001
     Positive68,961 (47.3)3,909 (11.3)17,314 (46.6)25,676 (61.5)22,062 (68.6)
     Negative22,783 (15.6)1,731 (5)6,732 (18.1)8,212 (19.7)6,108 (19)
     Unknown53,926 (37.0)28,914 (83.7)13,142 (35.3)7,895 (18.9)3,975 (12.4)
    Tumor grade<0.001
     Grade I17,359 (11.9)3,854 (11.2)4,282 (11.5)5,081 (12.2)4,142 (12.9)
     Grade II50,862 (34.9)10,301 (29.8)12,553 (33.8)15,450 (37)12,558 (39.1)
     Grade III/IV55,060 (37.8)11,848 (34.3)14,803 (39.8)16,177 (38.7)12,232 (38.1)
     Unknown22,389 (15.4)8,551 (24.7)5,550 (14.9)5,075 (12.1)3,213 (10)
    Tumor size<0.001
     1–10 mm49,926 (34.3)9,865 (28.6)12,612 (33.9)15,305 (36.6)12,144 (37.8)
     11–30 mm37,351 (25.6)7,510 (21.8)9,027 (24.3)11,038 (26.4)9,776 (30.4)
     >30 mm13,162 (9.0)2,204 (6.4)3,055 (8.2)4,156 (9.9)3,747 (11.7)
     Unknown45,231 (31.1)14,891 (43.2)12,494 (33.6)11,284 (27)6,478 (20.2)
    • ↵aχ2 test.

  • Table 2.

    Tumor features in patients diagnosed between 2012–2014

    n (%)
    Known tumor grade (n = 28,932)
     Grade I4,142 (14.3)
     Grade II12,558 (43.4)
     Grade III/IV12,232 (42.3)
    Known ER Status (n = 29,918)
     ER-positive26,170 (87.5)
     ER-negative3,748 (12.5)
    Known PR Status (n = 28,170)
     PR-positive22,062 (78.3)
     PR-negative6,108 (21.7)
    Known tumor size (n = 25,667)
     1–10 mm12,144 (47.3)
     11–30 mm9,776 (38.1)
     >30 mm3,747 (14.6)
    Known tumor grade, ER and/or PR Statusa (n = 26,552)
     Low riskb14,762 (55.6)
     Non-low risk11,790 (44.4)
    • ↵aRestricted to age ≥ 40 years.

    • ↵bGrade I/II, ER-positive, and/or PR-positive.

Additional Files

  • Figures
  • Tables
  • Supplementary Data

    • Supplementary Figure 1 - Figure S1: Age-adjusted ductal carcinoma in situ (DCIS) incidence trends.
    • Supplementary Materials - Contains ICD-0-3 histology codes included in the study
    • Supplementary Table 1 - Table S1: Tumor features in patients diagnosed between 2000 and 2014.
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Cancer Epidemiology Biomarkers & Prevention: 28 (8)
August 2019
Volume 28, Issue 8
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Incidence of Ductal Carcinoma In Situ in the United States, 2000–2014
Marc D. Ryser, Laura H. Hendrix, Mathias Worni, Yiling Liu, Terry Hyslop and E. Shelley Hwang
Cancer Epidemiol Biomarkers Prev August 1 2019 (28) (8) 1316-1323; DOI: 10.1158/1055-9965.EPI-18-1262

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Incidence of Ductal Carcinoma In Situ in the United States, 2000–2014
Marc D. Ryser, Laura H. Hendrix, Mathias Worni, Yiling Liu, Terry Hyslop and E. Shelley Hwang
Cancer Epidemiol Biomarkers Prev August 1 2019 (28) (8) 1316-1323; DOI: 10.1158/1055-9965.EPI-18-1262
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