@article{b2afadc629ce4dc195790570c338d8bb,
title = "Regional Variability in Percentage of Breast Cancers Reported as Positive for HER2 in California: Implications of Patient Demographics on Laboratory Benchmarks",
abstract = "Objectives: The expected regional variability in percent human epidermal growth factor receptor 2 (HER2)-positive breast cancers is not currently clear. Methods: Data from the 2006 to 2011 California Cancer Registry were examined by county and health service area. The influence of demographic and pathologic features was used in a multivariable logistic regression model to compare expected with observed HER2-positive percentages by region. Results: There was significant geographic variation by California counties (11.6%-26%). The reported HER2-positive percentage was higher when the population had higher stage, tumor size, grade, percent estrogen receptor negative, younger age, or lower socioeconomic status. Ethnic distribution of the population also influenced HER2-positive percentages. Using a multivariable logistic regression model, most regions had expected values based on their population characteristics; however, “outlier” regions were identified. Conclusions: These results deepen our understanding of population characteristics' influence on the distribution of HER2-positive breast cancers. Taking these factors into account can be useful when setting laboratory benchmarks and assessing test quality.",
keywords = "Benchmark, Breast cancer, HER2, Positivity rate, Quality, Variability",
author = "Lin, {Chieh Yu} and Carneal, {Eugene E.} and Lichtensztajn, {Daphne Y.} and Gomez, {Scarlett L.} and Clarke, {Christina A.} and Jensen, {Kristin C.} and Kurian, {Allison W.} and Allison, {Kimberly H.}",
note = "Funding Information: Supported by Stanford Cancer Institute and the National Cancer Institute's Surveillance, Epidemiology, and End Results Program under contract HHSN261201000140C. Funding Information: Corresponding author: Kimberly H. Allison, MD, Stanford University School of Medicine, 300 Pasteur Dr, Lane 235, Stanford, CA 94305-5324; allisonk@stanford.edu. Supported by Stanford Cancer Institute and the National Cancer Institute{\textquoteright}s Surveillance, Epidemiology, and End Results Program under contract HHSN261201000140C. Acknowledgments: We thank Norman Cyr for the figure preparation. The collection of cancer incidence data used in the current study was supported by the California Department of Public Health as part of the statewide cancer reporting program mandated by California Health and Safety Code Section 103885; the NCI{\textquoteright}s SEER Program under contract HHSN261201000140C awarded to the Cancer Prevention Institute of California, contract HHSN261201000035C awarded to the University of Southern California, and contract HHSN261201000034C awarded to the Public Health Institute; and the Centers for Disease Control and Prevention{\textquoteright}s National Program of Cancer Registries, under agreement U58DP003862-01 awarded to the California Department of Public Health. The ideas and opinions expressed herein are those of the authors and endorsement by the State of California, the Department of Publisher Copyright: {\textcopyright} American Society for Clinical Pathology, 2017. All rights reserved.",
year = "2017",
month = sep,
day = "1",
doi = "10.1093/AJCP/AQX063",
language = "English",
volume = "148",
pages = "199--207",
journal = "American Journal of Clinical Pathology",
issn = "0002-9173",
number = "3",
}