Abstract 3839: Is recent decline in breast cancer incidence equal across different US racial groups?
Bibliographic record
Abstract
Abstract Background: Recently, a sharp decline in breast cancer incidence rate was observed between 2002 and 2003 in the United States, evident only in women aged 50 years or older and for estrogen-receptor positive breast cancer. The plausible explanations for the decline have been controversial. Moreover, it is unclear if the reduction in incidence is equally distributed across all racial groups or whether the trends in breast cancers of different stages are similar. Methods: We examined temporal trends between 2000 and 2004 in invasive and in situ female breast cancer by race and tumor stage, using data from 17 cancer registries of the Surveillance, Epidemiology, and End Results program. Incidence rates were age-adjusted to the 2000 US standard population. We used jointpoint regressions to fit a series of joined straight lines on a log scale to the trends of quarterly, age-adjusted rates in women aged 50 to 69 years. Results: In Caucasian women, the incidence rate of invasive breast cancer was stable from 2000 to mid-2002 (-0.15% per quarter), significantly decreased to the end of 2003 (-2.41% per quarter, p=0.004), and stable to the end of 2004 (0.63% per quarter). Similar trends were seen for the rates of localized tumors and regional and distant tumors in Caucasians. The incidence rate of invasive breast cancer did not change significantly in the other racial groups: the quarterly changes throughout the study period were 0.07% in African Americans, -0.14% in American Indian/Alaska Natives, and -0.46% in Asian American/Pacific Islanders. The incidence rate of in situ breast cancer was stable in Caucasians (-0.23% per quarter), African Americans (0.26% per quarter), and American Indian/Alaska Natives (-0.97% per quarter). In Asian American/Pacific Islanders, the rate of in situ breast cancer was marginally significantly increased from 2000 to the mid-2002 (2.09% per quarter, p=0.054) but decreased to the end of 2004 (-3.20% per quarter, p=0.01). Conclusions: The decline in breast cancer incidence was not equal across US racial groups and the benefit was confined to Caucasians. This racial disparity is consistent with the hypothesis that discontinuation of hormone replacement therapy (HRT) may have caused the dramatic reduction. Compared with Caucasians, African Americans are more likely to have estrogen receptor negative tumors and less likely to use HRT, and thereby less likely to show a benefit from discontinuation of HRT. The finding that the rate of invasive breast cancer (but not in situ cancer) decreased suggests that exogenous estrogen serves as a promoter rather than an initiator of breast cancer. The trend of in situ cancer in Asian American/Pacific Islanders may be a result of slower uptake of mammographic screening in this population.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.009 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".