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Shin H.-R.,International Agency for Research on Cancer | Shin H.-R.,National Cancer Center | Joubert C.,International Agency for Research on Cancer | Boniol M.,International Agency for Research on Cancer | And 18 more authors.
Cancer Causes and Control | Year: 2010

Background: Incidence of breast cancer is rising in Asian countries, and breast cancer is the most common cancer among Asian women. However, there are few recent descriptive reports on the epidemiology of breast cancer among Eastern and Southeastern Asian populations. Methods: We examined incidence trends for invasive breast cancer in women aged ≥20 years from 15 registries in Eastern (China, Japan, the Republic of Korea, Taiwan) and Southeastern Asia (the Philippines, Singapore, Thailand) for the period 1993-2002 mainly using data from Cancer Incidence in Five Continents, Volumes VIII and IX. We compared trends in annual incidence rates and age-specific incidence curves over a 10-year period. We also compared the incidence rates of Asian-Americans with the rates of their Asian counterparts. Results: Breast cancer incidence rates increased gradually over time in all study populations. Rates were relatively high in Southeastern Asia and became progressively lower along a south-to-north gradient, with a fourfold geographic variation within the study populations. Age-specific incidence curves showed patterns that gradually changed according to incidence rates. Breast cancer incidence among Asian women living in the United States was 1.5-4 times higher than the corresponding incidence rate in the women's respective countries of origin. Conclusion: Breast cancer incidence is expected to continue to increase for the next 10 years in Asia and may approach rates reported among Asian-Americans. The number and mean age of breast cancer cases is expected to increase as the female Asian population ages, the prevalence of certain risk factors changes (early menarche, late menopause, low parity, late age at first live birth, and low prevalence of breastfeeding), and as Asian countries introduce mass screening programs. © 2010 Springer Science+Business Media B.V.


Shin H.-R.,International Agency for Research on Cancer | Shin H.-R.,National Cancer Center | Shin H.-R.,International Prevention Research Institute | Boniol M.,International Agency for Research on Cancer | And 15 more authors.
Cancer Science | Year: 2010

Breast cancer risk is increasing in most Asian female populations, but little is known about the long-term mortality trend of the disease among these populations. We extracted data for Hong Kong (1979-2005), Japan (1963-2006), Korea (1985-2006), and Singapore (1963-2006) from the World Health Organization (WHO) mortality database and for Taiwan (1964-2007) from the Taiwan cancer registry. The annual age-standardized, truncated (to ≥20 years) breast cancer death rates for 11 age groups were estimated and joinpoint regression was applied to detect significant changes in breast cancer mortality. We also compared age-specific mortality rates for three calendar periods (1975-1984, 1985-1994, and 1995-2006). After 1990, breast cancer mortality tended to decrease slightly in Hong Kong and Singapore except for women aged 70+. In Taiwan and Japan, in contrast, breast cancer death rates increased throughout the entire study period. Before the 1990s, breast cancer death rates were almost the same in Taiwan and Japan; thereafter, up to 1996, they rose more steeply in Taiwan and then they began rising more rapidly in Japan than in Taiwan after 1996. The most rapid increases in breast cancer mortality, and for all age groups, were in Korea. Breast cancer mortality trends are expected to maintain the secular trend for the next decade mainly as the prevalence of risk factors changes and population ages in Japan, Korea, and Taiwan. Early detection and treatment improvement will continue to reduce the mortality rates in Hong Kong and Singapore as observed in Western countries. © 2010 Japanese Cancer Association.


Chen W.-Q.,National Office for Cancer Prevention and Control and National Central Cancer RegistryNational Cancer CenterBeijing China | Hartman M.,National University of Singapore | Lim W.-Y.,National University of Singapore | Chia K.S.,National University of Singapore | And 2 more authors.
International Journal of Cancer | Year: 2016

Historically low breast cancer incidence rates among Asian women have risen worldwide; purportedly due to the adoption of a "Western" life style among younger generations (i.e., the more recent birth cohorts). However, no study has simultaneously compared birth cohort effects between both younger and older women in different Asian and Western populations. Using cancer registry data from rural and urban China, Singapore and the United States (1990-2008), we estimated age-standardized incidence rates (ASR), annual percentage change (EAPC) in the ASR, net drifts, birth cohort specific incidence rates and cohort rate ratios (CRR). Younger (30-49 years, 1943-1977 birth cohorts) and older women (50-79 years; 1913-1957 birth cohorts) were assessed separately. CRRs among Chinese populations were estimated using birth cohort specific rates with US non-Hispanic white women (NHW) serving as the reference population with an assigned CRR of 1.0. We observed higher EAPCs and net drifts among those Chinese populations with lower ASRs. Similarly, we observed the most rapidly increasing cohort-specific incidence rates among those Chinese populations with the lowest baseline CRRs. Both trends were more significant among older than younger women. Average CRRs were 0.06-0.44 among older and 0.18-0.81 among younger women. Rapidly rising cohort specific rates have narrowed the historic disparity between Chinese and US NHW breast cancer populations particularly in regions with the lowest baseline rates and among older women. Future analytic studies are needed to investigate risk factors accounting for the rapid increase of breast cancer among older and younger women separately in Asian populations. © 2016 UICC.


Mak V.,Princess Margaret Hospital | Ip D.,University of Hong Kong | Mang O.,Hong Kong Cancer Registry | Dalal C.,University of British Columbia | And 7 more authors.
Leukemia and Lymphoma | Year: 2014

The incidence of chronic lymphocytic leukemia (CLL) in the Asian population is up to 10 times lower than that in Caucasians. Studies on CLL in Asian residents in North America may help to determine the relative genetic and environmental causes of such a difference. Computerized records of CLL incidence from the combined British Columbia (BC) databases ( n = 2736) and the Hong Kong Cancer Registry (HKCR, n = 572) were traced. Ethnic Chinese cases of CLL in BC were identified ( n = 35). The world age standardized rates (WASRs) of CLL (per 100 000) were calculated in BC (1.71), HK (0.28) and BC Chinese (0.4), respectively. Using standard incidence ratios (SIRs), the observed BC Chinese case number was comparable to the figure projected from HK rates (SIR 1.3, p = 0.1) but significantly lower than the figure following BC rates (SIR 0.22, p < 0.0001). The difference was maintained over both genders, in all age groups and through the years. Our data over three decades suggest that genetic factors outplay environmental factors to give lower CLL rates in Chinese. © 2014 Informa UK, Ltd.


Chan V.,University of British Columbia | Song K.,University of British Columbia | Song K.,British Columbia Cancer Agency | Mang O.,Hong Kong Cancer Registry | And 2 more authors.
Leukemia and Lymphoma | Year: 2011

The etiology of plasma cell myeloma (PCM) is largely unknown. Its incidence varies widely in different ethnic groups. Migrant study may help determine the relative contributions of genetic versus environmental factors to PCM pathogenesis. We performed a retrospective review of the computerized records of all patients diagnosed with PCM between 1975 and 2004 in British Columbia (BC), and identified patients of Chinese ethnicity. This was compared with PCM incidence in Hong Kong (HK) Chinese. Age distributions of HK, BC and BC Chinese populations were obtained from the census departments to calculate world age-standardized rates (WASRs). The WASR of PCM over the 30-year period in BC Chinese was 1.64/100 000 person-years (95% confidence interval [CI] 1.371.93). This was similar to the WASR observed in HK (1.78, 95% CI 1.731.83), with a standardized incidence ratio (SIR) of 0.91 (95% CI 0.741.10). The rate was much lower than that in the BC non-Chinese background population (WASR 3.59, 95% CI 3.503.68; SIR 0.46, 95% CI 0.380.56). The lower rates in BC Chinese were maintained across all years, both genders and in all age groups above 45 years. Our observations suggest a strong genetic component as the cause of differences in the ethnic predisposition to PCM. © 2011 Informa UK, Ltd.

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