Abstract A106: Temporal trends in late-stage female breast cancer incidence in Texas, 2004-2023

Abstract

Our purpose is to describe trends in late-stage breast cancer (BC) incidence among women in Texas over a 20-year period, with comparisons to nationally representative data. Late-stage incidence helps assess screening impact and identify groups and regions needing targeted intervention. Texas provides a diverse setting for evaluating these patterns. We analyzed late-stage BC incidence data (2004-2023 for trends and 2019-2023 for 5-year age-adjusted rates) in Texas and compared results to nationally representative data using Surveillance, Epidemiology, and End Results (SEER) incidence data (which includes Texas). Late-stage cases were defined as primary BCs diagnosed at regional or distant SEER Summary Stage. Annual age-adjusted rates and standard errors were generated in SEER*Stat and annual percent change (APC) values were estimated using Joinpoint Regression software. The year 2020 was excluded from trend analyses but was included in the 2019-2023 rates. Analyses were stratified by race/ethnicity and public health service region. Trends were classified as rising, falling, or stable using NCI methodology. Among Texas women, late-stage BC incidence rates fell between 2004-2015, then rose by 2.1% per year through 2023; in contrast, rates in SEER registries remained stable after 2016. By 2021, Texas rates surpassed SEER rates. Incidence rose significantly in most Texas regions, with inflection points from 2010–2017. In Northwest TX-High Plains and West TX-Upper Rio Grande, non-significant increases were observed. Statistically significant rises were concentrated among White women in Northeast TX-Piney Woods and Southeast TX-Gulf Coast, Black women in Southeast TX-Gulf Coast and Hispanic women across most Texas regions. Among Black women, rates rose only in Southeast TX-Gulf Coast, with an APC of 2.9% per year after 2015. Hispanic women had the steepest rises, with the largest rise (5.7% per year) in North Central TX-Metroplex. During 2019–2023, Black women had the highest statewide late-stage incidence rate among racial/ethnic groups (52.7 per 100,000), and Black women in Southeast TX-Gulf Coast had the highest regional race/ethnicity-specific rate (56.4 per 100,000). West TX-Upper Rio Grande had the highest overall regional rate (45.8 per 100,000). Late-stage BC incidence has increased in Texas since 2015 despite stable trends across SEER registries. Increases were concentrated in the Southeast TX-Gulf Coast area and among Hispanic women across multiple regions, with important regional and racial/ethnic variation. Findings suggest a need to examine geographic differences in healthcare infrastructure and access to care, and to consider tailored education and awareness efforts to improve prevention and early detection. Microsoft Copilot was used to assist with trimming author-drafted text to meet abstract length requirements and improve clarity; all authors reviewed and verified the final abstract for accuracy and integrity prior to submission. Erin Gardner, Ali Rizvi, Paige Miller, Keisha Musonda, Arica Brandford, Khamron Micheals, Jennifer Cullen. Temporal trends in late-stage female breast cancer incidence in Texas, 2004-2023 [abstract]. In: Proceedings of the 19th AACR Conference on the Science of Cancer Health Disparities; 2026 Oct 18-21; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2026;35(10 Suppl):Abstract nr A106.