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Breast cancer incidence will increase by 50% by 2030
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PHILADELPHIA — The total number of invasive and in-situ breast cancer cases in the United States likely will increase 50% by 2030, according to study results presented at the American Association for Cancer Research Annual Meeting.
Increased incidence of ER-positive in-situ cancers, as well as a considerable increase in breast cancer cases among women aged 70 years or older, will account for much of the trend, results showed.
“We know that breast cancer is the most common malignancy among women in the U.S., and an estimated one in eight women will develop a breast cancer at some point during their lifetime,” Philip S. Rosenberg, PhD, of the division of cancer epidemiology and genetics at the NCI, said during a press conference. “We know that the burden in the U.S. is expected to increase. So for this study, we wanted to look at what the future is, what the incidence is going to look like and how many new cases are going to be diagnosed in the U.S going forward.”
No study has been performed to project future annual incidence of invasive and in-situ breast cancer — stratified by ER status — among women in the United States. That information could help clinicians tailor prevention and treatment efforts to ensure maximum effectiveness.
“We wanted to get a very detailed snapshot of this future scenario, so we broke it down by ER status, by invasive or in-situ behavior of the tumors and by the age at diagnosis,” Rosenberg said. “So we created a forecasting model for the U.S.”
Rosenberg and colleagues used SEER data, Census Bureau population projections and mathematical forecasting models to project the change in breast cancer cases between 2011 and 2030 among women aged 30 to 84 years. The researchers accounted for invasive and in-situ diagnoses.
Researchers determined the number of invasive and in-situ breast cancer cases would rise from 283,000 in 2011 to 441,000 in 2030. Their projections showed women aged 50 to 69 years would account for a smaller percentage of new breast cancer cases in 2030 than they did in 2011 (44% vs. 55%), but that women aged 70 to 84 years would account for a greater percentage of new breast cancer cases in 2030 than they did in 2011 (35% vs. 24%).
“It is important to understand that the oldest age group is the fastest-growing age group in the U.S.,” Rosenberg said. “The number of people in that age group is growing by 3.5% a year. A large part of the increase is because of the population growth.”
Researchers determined incidence of ER-positive invasive breast cancers will remain level, continuing to account for approximately 63% of cases. However, they projected ER-positive in-situ cancers will account for a larger percentage of cases in 2030 than they did in 2011 (29% vs. 19%). ER-negative cancers — which include difficult-to-treat triple-negative and HER-2–positive breast cancer subtypes — will account for a smaller percentage of cases in 2030 than in 2011 (9% vs. 17%), the researchers wrote.
Women who are younger at the time of first childbirth and do not breast-feed are at elevated risk for early onset of ER-negative tumors, so the fact more women are delaying child birth and choosing to breast-feed may contribute to the decline in incidence of ER-negative breast cancers, Rosenberg and colleagues wrote.
“Our results suggest that, although breast cancer overall is going to increase, different subtypes of breast cancer are moving in different directions and on different trajectories,” Rosenberg said in a press release. “These distinct patterns within the overall breast cancer picture highlight key research opportunities that could inform smarter screening and kinder, gentler and more effective treatment.” – by Cameron Kelsall
Reference:
Rosenberg PS, et al. Abstract 1850. Presented at: American Association for Cancer Research Annual Meeting; April 18-22, 2015; Philadelphia.
Disclosure: Rosenberg reports no relevant financial disclosures. Please see the full study for a list of all other researchers’ relevant financial disclosures.
Perspective
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Louis M. Weiner, MD
This modeling exercise builds on prior work that Rosenberg and colleagues reported in 2011. They demonstrate that the incidence of breast cancer is likely to rise significantly between now and 2030. This will be contributed by three factors: factor number one is that there will be more people in the U.S.; factor number two is that there will be an older population in the U.S.; and factor number three is that even when you adjust for those factors, there may be additional factors causing an increase in incidence per 100,000 people. Understanding that will be very important. Also of importance is that much of the burden will be in the in-situ cancers. These cancers are somewhat controversial in that many of them never develop into fully malignant lesions. It really points out a need to invest greater research resources into these important questions as we move forward.
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