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Abstract：
UK breast cancer incidence rates suggest that upper outer quadrant (UOQ) cancers have risen disproportionately compared with other areas over time. We aimed to provide a comparison of the trend in quadrant-specific breast cancer incidence between the United States (US) and England, and determine whether a disproportionate UOQ increase is present.
Surveillance Epidemiology and End Results (SEER) cancer registry data were obtained on 630,007 female breast cancers from 1975 to 2013. English cancer registry data were obtained on 1,121,134 female breast cancers from 1979 to 2013. Temporal incidence changes were analysed using negative binomial regression. Interaction terms determined whether incidence changes were similar between sites.
English breast cancer incidence in the UOQ rose significantly from 13% to 28% from 1979 to 2013 whereas no significant increase was observed among SEER data. The significant interaction between quadrant and year of diagnosis (p<0.001) in both SEER and English data indicates that breast cancer incidence in each quadrant changed at a different rate. Incidence in the UOQ rose disproportionately compared to the nipple (SEER IRR=0.81, p<0.001; England IRR=0.78, p<0.001) and axillary tail (SEER IRR=0.87, p=0.018; England IRR=0.69, p<0.001) in both SEER and England. In addition, incidence rose disproportionately in the UOQ compared to non-site-specific tumours in England (Overlapping lesions IRR=0.81, p=0.002; NOS IRR=0.78, p<0.001). The proportion of non-site-specific tumours was substantially higher in England than SEER throughout the study period (62% in England; 39% in SEER).
Breast cancer incidence in the UOQ increased disproportionately compared to non-site-specific tumours in England but not in SEER, likely due to the decrease in non-site-specific tumours observed in England over time. There may be real differences in incidence between the two countries, possibly due to differences in aetiology, but is much more likely to be an artefact of changing data collection methods and improvements in site coding in either country.
Surveillance Epidemiology and End Results (SEER) cancer registry data were obtained on 630,007 female breast cancers from 1975 to 2013. English cancer registry data were obtained on 1,121,134 female breast cancers from 1979 to 2013. Temporal incidence changes were analysed using negative binomial regression. Interaction terms determined whether incidence changes were similar between sites.
English breast cancer incidence in the UOQ rose significantly from 13% to 28% from 1979 to 2013 whereas no significant increase was observed among SEER data. The significant interaction between quadrant and year of diagnosis (p<0.001) in both SEER and English data indicates that breast cancer incidence in each quadrant changed at a different rate. Incidence in the UOQ rose disproportionately compared to the nipple (SEER IRR=0.81, p<0.001; England IRR=0.78, p<0.001) and axillary tail (SEER IRR=0.87, p=0.018; England IRR=0.69, p<0.001) in both SEER and England. In addition, incidence rose disproportionately in the UOQ compared to non-site-specific tumours in England (Overlapping lesions IRR=0.81, p=0.002; NOS IRR=0.78, p<0.001). The proportion of non-site-specific tumours was substantially higher in England than SEER throughout the study period (62% in England; 39% in SEER).
Breast cancer incidence in the UOQ increased disproportionately compared to non-site-specific tumours in England but not in SEER, likely due to the decrease in non-site-specific tumours observed in England over time. There may be real differences in incidence between the two countries, possibly due to differences in aetiology, but is much more likely to be an artefact of changing data collection methods and improvements in site coding in either country.
摘要：
英国乳腺癌发病率表明，随着时间的推移，上外象限（UOQ）癌症与其他地区相比不成比例地上升。我们旨在提供美国（美国）和英国之间象限特定乳腺癌发病率趋势的比较。并确定是否存在不成比例的UOQ增加。
从1975年至2013年，获得了630,007名女性乳腺癌的监测流行病学和最终结果（SEER）癌症登记数据。从1979年至2013年，获得了1,121,134名女性乳腺癌的英国癌症登记数据。使用负二项回归分析时间发生率变化。相互作用术语确定了站点之间的发生率变化是否相似。
从1979年到2013年，UOQ中的英国乳腺癌发病率从13％显着上升到28％，而SEER数据中没有观察到显着增加。SEER和英语数据中象限和诊断年份之间的显着相互作用（p<0.001）表明，每个象限中的乳腺癌发病率以不同的速率变化。与SEER和英格兰的乳头（SEERIRR=0.81，p<0.001；英格兰IRR=0.78，p<0.001）和腋尾（SEERIRR=0.87，p=0.018；英格兰IRR=0.69，p<0.001）相比，UOQ的发生率不成比例地上升。此外,与英格兰的非特定部位肿瘤相比,UOQ的发病率不成比例地上升(重叠病变IRR=0.81,p=0.002;NOSIRR=0.78,p<0.001)。在整个研究期间，英格兰非部位特异性肿瘤的比例明显高于SEER（英格兰为62％；SEER为39％）。
与英格兰的非位点特异性肿瘤相比，UOQ中的乳腺癌发病率不成比例地增加，但在SEER中却没有。可能是由于随着时间的推移，在英格兰观察到的非部位特异性肿瘤减少。两国之间的发病率可能存在真正的差异，可能是由于病因的不同,但更有可能是改变数据收集方法和改进网站编码的产物。
从1975年至2013年，获得了630,007名女性乳腺癌的监测流行病学和最终结果（SEER）癌症登记数据。从1979年至2013年，获得了1,121,134名女性乳腺癌的英国癌症登记数据。使用负二项回归分析时间发生率变化。相互作用术语确定了站点之间的发生率变化是否相似。
从1979年到2013年，UOQ中的英国乳腺癌发病率从13％显着上升到28％，而SEER数据中没有观察到显着增加。SEER和英语数据中象限和诊断年份之间的显着相互作用（p<0.001）表明，每个象限中的乳腺癌发病率以不同的速率变化。与SEER和英格兰的乳头（SEERIRR=0.81，p<0.001；英格兰IRR=0.78，p<0.001）和腋尾（SEERIRR=0.87，p=0.018；英格兰IRR=0.69，p<0.001）相比，UOQ的发生率不成比例地上升。此外,与英格兰的非特定部位肿瘤相比,UOQ的发病率不成比例地上升(重叠病变IRR=0.81,p=0.002;NOSIRR=0.78,p<0.001)。在整个研究期间，英格兰非部位特异性肿瘤的比例明显高于SEER（英格兰为62％；SEER为39％）。
与英格兰的非位点特异性肿瘤相比，UOQ中的乳腺癌发病率不成比例地增加，但在SEER中却没有。可能是由于随着时间的推移，在英格兰观察到的非部位特异性肿瘤减少。两国之间的发病率可能存在真正的差异，可能是由于病因的不同,但更有可能是改变数据收集方法和改进网站编码的产物。
