Nonwhite women are significantly more likely than white women to be diagnosed with breast cancer before age 50 years, according to an analysis of Surveillance, Epidemiology, and End Results (SEER) Program data for almost 750,000 women.

“Our finding challenges established norms with regard to screening practices and provides empirical evidence that race-based screening should be considered,” Sahael M. Stapleton, MD, and his associates at Massachusetts General Hospital, Boston, wrote in a research letter published online March 7 by JAMA Surgery .

Early breast cancer diagnosis was most common in Hispanic women, with 34.9% of diagnoses occurring before the age of 50 years. The corresponding proportions were 32.8% for Asian women, 31.0% for black women, and 23.6% for white women, they reported.

The researchers charted age at diagnosis and race/ethnicity for the 747,763 women in the SEER database from Jan. 1, 1973, through Dec. 31, 2010; this revealed “two distinct distribution patterns of age at diagnosis for female breast cancers: White patients peak in their 60s, whereas nonwhite patients peak in their 40s,” the investigators wrote.

Their calculations show that “screening ages would need to decrease to 47 years for black, 46 years for Hispanic, and 47 years for Asian patients … to achieve a similar capture rate for nonwhite patients as current guidelines do for white patients” at 50 years of age.

Dr. Stapleton reported receiving support from two Massachusetts General Hospital fellowships. No other disclosures were reported.

SOURCE: Stapleton SM et al. JAMA Surg. 2018 Mar 7. doi: 10.1001/jamasurg.2018.003 .


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