Disparities in mortality-to-incidence ratios by race/ethnicity for female breast cancer in New York City, 2002-2016.

BACKGROUND: Racial disparities in New York City (NYC) breast cancer incidence and mortality rates have previously been demonstrated. Disease stage at diagnosis and mortality-to-incidence ratio (MIR) may present better measures of differences in screening and treatment access. Racial/ethnic trends in NYC MIR have not previously been assessed. METHODS: Mammogram rates were compared using the NYC Community Health Survey, 2002-2014. Breast cancer diagnosis, stage, and mortality were from the New York State Cancer Registry, 2000-2016. Primary outcomes were MIR, the ratio of age-adjusted mortality to incidence rates, and stage at diagnosis. Joinpoint regression analysis identified significant trends. RESULTS: Mammogram rates in 2002-2014 among Black and Latina women ages 40 and older (79.9% and 78.4%, respectively) were stable and higher than among White (73.6%) and Asian/Pacific-Islander women (70.4%) (P < .0001). There were 82 733 incident cases of breast cancer and 16 225 deaths in 2000-2016. White women had the highest incidence, however, rates among Black, Latina, and Asian/Pacific Islander women significantly increased. Black and Latina women presented with local disease (Stage I) less frequently (53.2%, 57.6%, respectively) than White (62.5%) and Asian/Pacific-Islander women (63.0%). Black women presented with distant disease (Stage IV) more frequently than all other groups (Black 8.7%, Latina 5.8%, White 6.0%, and Asian 4.2%). Black women had the highest breast cancer mortality rate and MIR (Black 0.25, Latina 0.18, White 0.17, and Asian women 0.11). CONCLUSIONS: More advanced disease at diagnosis coupled with a slower decrease in breast cancer mortality among Black and Latina women may partially explain persistent disparities in MIR especially prominent among Black women. Assessment of racial/ethnic differences in screening quality and access to high-quality treatment may help identify areas for targeted interventions to improve equity in breast cancer outcomes.

Colorectal Cancer Incidence and Mortality Rates Among New York City Adults Ages 20-54 years during 1976-2015.

Colorectal cancer (CRC) incidence rates are rising in younger Americans and mortality rates are increasing among younger white Americans. We used New York State Cancer Registry data to examine New York City CRC incidence and mortality trends among adults ages 20-54 years by race from 1976 to 2015. Annual percent change (APC) was considered statistically significant at P less than .05 using a two-sided test. CRC incidence increased among those ages 20-49 years, yet blacks had the largest APC of 2.2% (1993-2015; 95% confidence interval [CI] = 1.4% to 3.1%) compared with 0.5% in whites (1976-2015; 95% CI = 0.2% to 0.7%). Among those aged 50-54 years, incidence increased among blacks by 0.8% annually (1976-2015; 95% CI = 0.4% to 1.1%), but not among whites. CRC mortality decreased among both age and race groups. These findings emphasize the value of local registry data to understand trends locally, the importance of timely screening, and the need for clinicians to consider CRC among all patients with compatible signs and symptoms.