Breast cancer patterns and lifetime risk of developement breast cancer among Puerto Rican females

OBJECTIVES: The purpose of this study was to evaluate the epidemiologic patterns of breast cancer and to estimate the lifetime risk probability of developing breast cancer among Hispanic females using cancer data from Puerto Rico. BACKGROUND: The age-adjusted breast cancer incidence rate (per 100,000) in Puerto Rico increased from 15.3 in 1960-1964 to 43.3 in 1985-1989. The age-adjusted breast cancer mortality rate (per 100,000) increased from 5.7 to 10.6 comparing the same two time periods (1960-1964 vs 1985-1989). Nevertheless, in 1985-1989 breast cancer incidence rate was higher in US White females (110.8 per 100,000) compared to Puerto Rican females (51.4 per 100,000; age-adjusted to the 1970 US standard population). The breast cancer mortality rate was also higher in US White females (27.4 per 100,000) than in Puerto Rican females (15.1 per 100,000; age-adjusted to the 1970 US standard population) during 1985-1989. METHODS: A multiple decrement life table was constructed applying age-specific incidence and mortality rates from cross-sectional data sets (1980-1984 and 1985-1989 data for Puerto Rican females and 1987-1989 SEER data sets for US White and Black females) to a hypothetical cohort of 10,000,000 women. The probability of developing invasive breast cancer was computed for the three groups using the long version of DEVCAN: Probability of DEVeloping CANcer software, version 3.3. RESULTS: The lifetime risk of developing breast cancer was 5.4 percent for Puerto Rican females, compared to 8.8 percent for US Black females and 13.0 percent for US White females. Lifetime risk for Puerto Rican females increased from 4.5 percent in 1980-1984 to 5.4 percent in 1985-1989. CONCLUSIONS: Lifetime risk of breast cancer appears to be increasing in Puerto Rico, but remains lower than the probability for US White females. Therefore, the application of lifetime probability of developing invasive breast cancer estimated for the US female population will overestimate the risk for the Puerto Rican female population.

Condiciones de salud y limitaciones funcionales en la poplación de edad avanzada de la Región Universitaria de la Salud de Puerto Rico: aspectos metodológicos y estimación de prevalencias / Health status and functional limitations in the elderly population of the University Region of Health of Puerto Rico: methodologic aspects and prevalence estimates

In order to plan the health services for the elderly population, it is necessary to quantify their health status and their functional capacity. In Puerto Rico, few epidemiological studies have been conducted regarding functional capacity and chronic diseases in the elderly population. One of the difficulties to undertake these studies is the high cost and risks to move this population for clinical exams, in addition to the methodology limitation of self-report in the elderly population. This study shows the use of logistic regression to estimate the prevalence of chronic diseases and functional capacity, when the observed data are not consisted with the planed sampling scheme. Four hundred and eighty-seven elderly persons (65 yr. and over) were interviewed in the municipalities of Canóvanas, Carolina, Loíza and Trujillo Alto in Puerto Rico, using a cross-sectional design. More than half of the elderly had visual problems (IC 95 percent: 54.8 percent, 63.8 percent), arthritis (IC 95 percent: 52.7 percent, 61.5 percent) and hypertension (IC 95 percent: 47.3 percent, 56.3 percent). In the case of hypertension, significant differences (p < 0.05) by sex were observed, where women reported a higher prevalence than men. One of the higher prevalence in the functional capacity status was with urine accidents. More than one-third of the population is estimated to have this problem (IC 95 percent: 34.7 percent, 43.4 percent). One-fourth of the population had limitations with going out for shopping (IC 95 percent: 23.9 percent, 31.9 percent) and using public and private transportation (IC 95 percent: 19.5 percent, 26.9 percent). We conclude that the applied methodology was consistent with the estimation presented in the literature and statistics from the Puerto Rico Health Department. However, it is necessary to continue assessing the design and analytical methodology, in order to undertake consistent and periodic evaluations of the elderly population.