title: Inter- and intra-ethnic differences for female breast carcinoma incidence in the continental United States and in the state of Hawaii.
abstract: BACKGROUND
  Ethnic diversity is well-documented for female breast carcinoma incidence in the continental US but is not so well-established in the state of Hawaii.
  
  
  METHODS
  Using the Surveillance, Epidemiology, and End Results (SEER) program, we analyzed n=323,607 in situ and invasive female breast cancer cases for major ethnic groups in the continental US and in Hawaii, diagnosed during the years 1992-2002.
  
  
  RESULTS
  In the continental US, age-specific incidence rate patterns and prognostic factor profiles were good-risk for Asian or Pacific Islanders (API), intermediate for Whites, and poor-risk for Blacks. For example, early age-at-onset, high nuclear grade, aggressive histopathologic subtypes, and hormone receptor negative expression was associated with Black race in the continental US. In Hawaii, age-specific rate and prognostic profiles were more favorable for API than for White women, albeit not so striking as in the continental US.
  
  
  CONCLUSIONS
  We observed inter- and intra-ethnic differences for female breast carcinoma in the continental US and in the state of Hawaii. While inter-racial disparities were expected, intra-racial differences were somewhat unexpected and possibly due to variations in racial subgroup mixing and/or cultural assimilation. For example, API women with breast carcinoma in the continental US included 96.03% Asians and 2.4% Pacific Islanders. In contrast, API women with breast carcinoma in Hawaii included 76.52% Asians and 23.46% Pacific Islanders. Moreover, APIs were more likely to be first-generation migrants in the continental US ( approximately 92%) than in Hawaii ( approximately 34%). Future studies should attempt to disaggregate racial data to separately characterize epidemiological patterns for individual ethnic groups.
authors.affiliation: School of Public Health and Health Sciences, George Washington University, Washington, DC, USA.
authors.forename: Megan
authors.initials: M
authors.lastname: Fong
authors.forename: Donald E
authors.initials: DE
authors.lastname: Henson
authors.forename: Susan S
authors.initials: SS
authors.lastname: Devesa
authors.forename: William F
authors.initials: WF
authors.lastname: Anderson
mesh_terms: D000230:Adenocarcinoma / Q000208:ethnology / Q000209:etiology / Q000473:pathology; D002288:Adenocarcinoma, Mucinous / Q000208:ethnology / Q000209:etiology / Q000473:pathology; D001741:Black or African American; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D001213:Asian; D001943:Breast Neoplasms / Q000208:ethnology* / Q000209:etiology / Q000473:pathology; D018270:Carcinoma, Ductal, Breast / Q000208:ethnology / Q000209:etiology / Q000473:pathology; D015331:Cohort Studies; D005006:Ethnicity; D005260:Female; D006254:Hawaii / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D018299:Neoplasms, Ductal, Lobular, and Medullary / Q000208:ethnology / Q000209:etiology / Q000473:pathology; D016017:Odds Ratio; D010139:Pacific Islands; D011159:Population Surveillance; D011960:Receptors, Estrogen / Q000032:analysis; D011980:Receptors, Progesterone / Q000032:analysis; D012307:Risk Factors; D018426:SEER Program; D015996:Survival Rate; D014481:United States / Q000453:epidemiology; D044465:White People
chemical_list: D011960:Receptors, Estrogen; D011980:Receptors, Progesterone