Top 5 Takeaways

1. Overall Decrease in Incidence: Breast cancer incidence among women aged ≥20 years decreased an average of 0.3% per year from 1999 to 2018.
2. Racial and Ethnic Variations: Incidence increased among non-Hispanic Asian or Pacific Islander women and decreased among non-Hispanic White women.
3. Age-Specific Trends: Incidence increased among women aged 20–39 years but decreased among women aged 50–64 and ≥75 years.
4. Screening Recommendations: The U.S. Preventive Services Task Force recommends biennial mammography screening for women aged 50–74 years, but younger women might benefit from discussing risk reduction with healthcare providers.
5. Public Health Implications: Tailored breast cancer prevention and control programs are necessary to address state- or county-level incidence rates and prevent health disparities.

Original Article Author and Citation

Corresponding Author

Taylor D. Ellington, tellington@cdc.gov

Suggested Citation

Ellington TD, Miller JW, Henley SJ, Wilson RJ, Wu M, Richardson LC. Trends in Breast Cancer Incidence, by Race, Ethnicity, and Age Among Women Aged ≥20 Years — United States, 1999–2018. MMWR Morb Mortal Wkly Rep 2022;71:43–47. DOI: http://dx.doi.org/10.15585/mmwr.mm7102a2

Summary

This report examines trends in breast cancer incidence among women aged ≥20 years in the United States from 1999 to 2018. Overall, the incidence decreased by an average of 0.3% per year. However, trends varied by race, ethnicity, and age, with increases observed among non-Hispanic Asian or Pacific Islander women and younger women aged 20–39 years, and decreases among non-Hispanic White women and older women aged 50–64 and ≥75 years. The findings suggest that younger women might benefit from discussing breast cancer risk and prevention strategies with healthcare providers.

Methods

The study utilized data from U.S. Cancer Statistics (USCS) covering 97% of the U.S. population. Breast cancer incidence rates were examined by race/ethnicity and age group. Trends were analyzed using joinpoint regression to estimate annual percent change (APC) and average annual percent change (AAPC). Incidence rates were calculated with SEER*Stat software, and APC and AAPC were calculated using Joinpoint software.

Discussion

The analysis revealed that breast cancer incidence trends differ significantly by demographic characteristics. The increase in incidence among non-Hispanic Asian or Pacific Islander women and younger women aged 20–39 years highlights the need for targeted prevention and control programs. Factors such as obesity, physical inactivity, alcohol use, and hormone replacement therapy use were identified as modifiable risk factors contributing to breast cancer risk.

Conclusion

Breast cancer incidence trends indicate the need for tailored prevention and control programs to address specific demographic groups. Public health strategies should focus on promoting healthy behaviors and ensuring appropriate screening practices. Women aged 20–49 years might benefit from discussions with healthcare providers about breast cancer risk and prevention.

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