Breast cancer incidence and mortality, by age, stage and molecular subtypes, by race/ethnicity in Canada

Anna N Wilkinson; Carmina Ng; Larry F Ellison; Jean M Seely

doi:10.1093/oncolo/oyae283

Breast cancer incidence and mortality, by age, stage and molecular subtypes, by race/ethnicity in Canada

Oncologist. 2024 Nov 2:oyae283. doi: 10.1093/oncolo/oyae283. Online ahead of print.

Authors

Anna N Wilkinson¹, Carmina Ng², Larry F Ellison², Jean M Seely³

Affiliations

¹ Department of Family Medicine, University of Ottawa, Ottawa, Ontario, K1G 5Z3, Canada.
² Centre for Population Health Data, Statistics Canada, Government of Canada, Ottawa, Ontario, K1A 0T6, Canada.
³ Department of Radiology, University of Ottawa, Ottawa, Ontario, K1H 8L6, Canada.

PMID: 39487041
DOI: 10.1093/oncolo/oyae283

Abstract

Background: Breast cancer (BC) characteristics and outcomes in Canada related to race/ethnicity are not currently documented.

Methods: Age-specific and age-standardized BC incidence and mortality rates, age distribution of cases, proportions of stage, and molecular subtypes were calculated for women aged 20+, by race/ethnicity, using 2006 and 2011 Canadian Census Health and Environment Cohort databases of linked census, cancer, and death data.

Results: In 47 105 BC cases, age-specific incidence rates were higher in Filipina (rate ratio (RR) = 1.27, 95%CI, 1.11-1.46) and multiethnicity (RR = 1.57, 95% CI, 1.18-2.08) compared to White women aged 40-49; and Filipina (RR = 1.16, 95% CI, 1.02-1.31) and Arab (RR = 1.3, 95% CI, 1.02-1.65) women aged 50-59. Median age at diagnosis was 63 among White women and 52-60 among other race/ethnicity groups, with 22.4%-41.1% of cases (P < .001) diagnosed before age 50 compared to 16.6% among White women. BC was diagnosed at stage I less frequently among Filipina (38.6%), Black (39.2%), South Asian (40.6%), and First Nations (40.7%) compared to White (46.5%) and Chinese (49.6%) (P < .05) women. Black women had higher proportions of BC diagnoses at stages III and IV combined (26.3%) than White women (17.0%, P = .001). The proportion of triple-negative BC among Black women (20.5%) was higher than among White (9.5%, P < .001). Compared to White, age-specific BC mortality rates were higher among Black women aged 40-49 (RR = 1.4, 1.06-1.85) as well as First Nations (RR = 1.21, 1.01-1.45) and Métis (RR = 1.48, 1.15-1.91) women aged 60-69.

Interpretation: Compared to White women, other Canadian women had an earlier peak age of BC diagnosis and higher proportions of cases diagnosed under age 50. Although many race/ethnicity groups had lower BC incidence and mortality than White, the higher age-specific BC mortality among Black 40-49 and First Nations and Métis women 60-69 merits further investigation.

Keywords: breast cancer; cancer registry; ethnicity; outcomes; race; women’s health.

Abstract

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