Abstract
Development of statistical model for cancer incidence trend predictions can provide a sound and accurate foundation for planning a comprehensive national strategy for optimal partitioning of research resources. Several studies in the past showed that that there are racial/ethnic disparities exist between breast cancer incidence rates among black and white women in the United States. Some of the studies also showed that the disparity in breast cancer incidence rates among white and black US women is widening, with relatively higher incidence rates among black women. In this paper, we apply functional time series (FTS) models on the age-specific breast cancer incidence rates for these two major groups of women in US, and forecast their age-incidence curves. The data are obtained from the Surveillance, Epidemiology and End Results (SEER) program of the United States. We use annual unadjusted breast cancer incidence rates from 1973 to 2013 in 5-year agegroups (15-19, 20-24, 25-29, 30-34, 35-39, 40-44, 45–49, 50–54, 55–59, 60–64, 65–69, 70–74, 75–79, 80–84 and 85+). Age-specific cancer incidence curves are obtained using nonparametric smoothing methods. The curves are then decomposed using functional data paradigm and we fit functional time series (FTS) models for each population of women separately. The smoothed incidence curves are then forecasted and prediction intervals are calculated. Fifteen-year forecasts indicate an overall increase in future breast cancer incidence rates for both groups of women. This increase appears to be faster among black women and relatively slower among the whites. The projections suggest a need for equal delivery of quality care to eliminate breast cancer disparities among the two major groups of women in US.
Highlights
Breast cancer is the most common cancer among women worldwide
It is found that compared to white women, black women have an increased risk for stages III and stage-IV tumors, age at diagnosis and year of diagnosis [3,4].Some studies suggested that the black women in comparison with white women are more likely to be diagnosed with breast cancer at a distant stage of the disease [5]
The expected increase in future breast cancer incidence rates is higher for older ages (55 years and above) and relatively slower in the young age-groups
Summary
Breast cancer is the most common cancer among women worldwide. It is documented that the global burden of breast cancer is expected to increase up to 2 million and over the new cancer cases per year by 2030 [1]. For women in the United States, breast cancer is the most common cancer, excluding skin cancers. It is estimated that there are more than 3.5 million women living in the United States with a history of invasive breast cancer [2]. Several epidemiologic studies suggest that substantial disparities exist between black and white women in their breast cancer incidence. In addition to these disparities, there are substantial black-white differences in other factors, e.g. cancer stage at the time of diagnosis and five-year survival after diagnosis. It is found that compared to white women, black women have an increased risk for stages III and stage-IV tumors, age at diagnosis and year of diagnosis [3,4].Some studies suggested that the black women in comparison with white women are more likely to be diagnosed with breast cancer at a distant stage of the disease [5]
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