Breast cancer incidence and mortality in Barbados, West Indies: Findings from the Barbados National Cancer Study Free

A22

Purpose:
 To describe incidence and death rates for breast cancer in a predominantly African-origin population (93%) from Barbados, West Indies. This population shares a common heredity with African-Americans (but lower admixture), with similarly high rates of lifestyle-related non-communicable disease.
 Methods:
 We identified all new cases of histologically confirmed breast cancer occurring in Barbados between July 2002 and April 2006. We also used death certification records to ascertain breast cancer death rates for the 10-year period commencing January 1995.
 Results:
 There were 391 incident breast cancer cases, for an annual age-standardized rate (US 2000 population) of 77.1 per 100,000 (95% CI: 69.4 - 84.7). Overall incidence rates in Barbados were lower than comparable rates in African Americans (in 2004: 79.2 per 100,000 in Barbados versus 120.6 per 100,000 in African-Americans the US). However, rates among younger women (less than 50 years) were similar in Barbados and the US. Rates diverged thereafter, with elderly Barbadians (65 years and over) having less than half the rate of elderly Black Americans. The age-standardized annual death rate in Barbadian women was 33.6 per 100,000; a rate comparable to the mortality experience of African-American women.
 Conclusion:
 The incidence of breast cancer in women 50 years and older was lower in Barbados than in comparable populations from the US, while similar rates were found in younger women. Environmental factors may underpin disease in postmenopausal women, and strategies aimed at lowering risk exposures could be key in reducing the burden of disease in older women. In spite of lower breast cancer incidence overall, mortality outcomes were similar to those experienced in the US. This has implications for clinical and public health interventions aimed at earlier detection and optimal treatment of breast cancer to improve outcomes.
 Acknowledgements: National Human Genome Research Institute