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The high and heterogeneous burden of breast cancer in Hawaii: A unique multiethnic U.S. Population.

ABSTRACT: BACKGROUND:While breast cancer incidence and mortality rates differ across racial/ethnic populations in the U.S., little is known about Asian and Pacific Island subpopulations. Hawaii is one of the most racially/ethnically diverse states in the U.S. Overall, Hawaii ranks 5th highest for breast cancer incidence in the nation (2010-2014) and rates have increased in recent years despite a stable national trend. In contrast, for breast cancer mortality, Hawaii has the 3rd lowest rate in the nation, with rates demonstrating a steady decline for nearly 3 decades. METHODS:We examined incidence and mortality trends from 1984-2013 across the five major racial/ethnic populations of Hawaii (Native Hawaiian, White, Japanese, Chinese, and Filipino) using Hawaii's Surveillance, Epidemiology, and End Results (SEER) registry data. RESULTS:With the exception of Chinese, all groups experienced increasing incidence over the thirty year period. While Japanese experienced the most pronounced recent increase, with incidence now exceeding that of Whites, their mortality rates have remained low for decades. Native Hawaiians have consistently had the highest incidence and mortality rates in the state. The incidence rates of hormone receptor (HR)-positive breast cancer were higher among Japanese and Native Hawaiians as compared to Whites. Relative to Whites, Native Hawaiians also had a higher incidence rate of the HER2-positive subtype and, Japanese, of the triple-negative (HR-/HER2-) subtype of breast cancer. CONCLUSIONS:Studies such as this underscore the importance of considering the heterogeneity in breast cancer rates and subtypes across the different racial/ethnic populations.

SUBMITTER: Loo LWM

PROVIDER: S-EPMC6358492 | biostudies-literature | 2019 Feb

REPOSITORIES: biostudies-literature

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The high and heterogeneous burden of breast cancer in Hawaii: A unique multiethnic U.S. Population.

Loo Lenora W M LWM Williams Makana M Hernandez Brenda Y BY

Cancer epidemiology 20181130

<h4>Background</h4>While breast cancer incidence and mortality rates differ across racial/ethnic populations in the U.S., little is known about Asian and Pacific Island subpopulations. Hawaii is one of the most racially/ethnically diverse states in the U.S. Overall, Hawaii ranks 5<sup>th</sup> highest for breast cancer incidence in the nation (2010-2014) and rates have increased in recent years despite a stable national trend. In contrast, for breast cancer mortality, Hawaii has the 3<sup>rd</su ...[more]

PMID: 30503975

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Project description:Background: Hypertensive disorders of pregnancy are a recognized risk factor of a woman's future cardiovascular risk. The potential role of micronutrients in mitigating hypertensive disorders is not fully understood. This study examined maternal postpartum plasma B vitamin profiles by hypertensive disorders of pregnancy in a high-risk multiethnic U.S. population. Materials and Methods: The analyses included 2584 mothers enrolled within 3 days postpartum at the Boston Medical Center. Hypertensive disorders of pregnancy included gestational hypertension and pre-eclampsia disorders (pre-eclampsia, eclampsia, hemolysis, elevated liver enzymes, and/or low platelets syndrome) as documented in the medical records. Plasma folate, vitamin B12, and homocysteine levels were measured in blood samples collected at enrollment. Kernel density plots and multivariable regressions were used to examine the relationship between hypertensive disorders and postpartum B vitamin profiles. Results: Of the 2584 mothers, 10% had pre-eclampsia disorders that were associated with significantly lower plasma folate (adjusted beta coefficient (aβ): -0.10; 95% CI: -0.22 to -0.06) and increased homocysteine (aβ: 0.08; 95% CI: 0.04-0.13), but not with vitamin B12 concentrations. These associations remained robust after adjusting for a range of pertinent covariables and were more pronounced in non-Hispanic Black women compared with other groups. However, gestational hypertension was not significantly associated with any postpartum biomarker. Conclusions: We found that pre-eclampsia disorders, but not gestational hypertension, was associated with lower folate and higher homocysteine levels postpartum, especially among Black mothers. This finding, if further confirmed, may have implications for postpartum care, including attention to maternal micronutrient status to reduce and prevent hypertensive disorders in pregnancy-associated consequences in subsequent pregnancies and lifespan. Registration date: July 25, 2017; Registry website: https://clinicaltrials.gov/ct2/show/NCT03228875.

Dataset Information

The high and heterogeneous burden of breast cancer in Hawaii: A unique multiethnic U.S. Population.

Publications

The high and heterogeneous burden of breast cancer in Hawaii: A unique multiethnic U.S. Population.

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