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Breast cancer incidence, mortality rates vary by location
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Breast cancer mortality rates have decreased in a majority of high-income countries despite increasing or stable breast cancer incidence in those areas, according to the results of an epidemiological registry study.
However, incidence and mortality rates have increased in a number of low- and middle-income countries, according to the researchers.
“Mortality rates are decreasing in most high-income countries, even as incidence rates are increasing or stable,” Carol E. DeSantis, MPH, senior epidemiologist with the American Cancer Society, said in a press release. “That’s the good news. But, of real concern are increasing incidence and mortality rates in a number of countries, particularly those undergoing rapid changes in human development.”
DeSantis and colleagues evaluated data on the estimated numbers of new breast cancer cases, cancer deaths, incidence and mortality rates and 5-year prevalence by world region and country using the International Agency for Research on Cancer and GLOBOCAN. Further, they used the WHO mortality database to ascertain incidence rates (between 2006 and 2007) from 39 countries and mortality rates (between 2008 and 2012) from 57 countries.
Approximately 1.7 million new breast cancer diagnoses and 521,900 deaths occurred worldwide in 2012. Asian countries — which represented 59% of the global population — accounted for 39% of new cases, 44% of deaths and 37% of the world’s 5-year prevalent cases.
North America (defined as the U.S. and Canada) accounted for 15% of new cases, 9% of deaths and 17% of prevalent cases, despite comprising only 5% of the global population. In contrast, Africa — representing 15% of the global population — represented 8% of new cases, 12% of deaths and 1% of prevalence.
Overall, breast cancer incidence increased in 22 of 39 countries with available data, including those with historically higher rates — such as countries in Europe — an in countries with historically lower incidence rates, such as many countries in Latin America, Asia and Africa.
Death rates significantly decreased in 34 of 57 countries included in the study.
Of 32 countries with incidence and mortality rates available, a concurrent increase in incidence and decrease in mortality occurred in nine countries, mainly located in Northern and Western Europe.
Countries in which mortality and incidence decreased — by 0.8% to 1.6% per year — included France, Israel, Italy, Norway and Spain.
Countries in which mortality and incidence increased included Colombia, Ecuador and Japan.
Increases in mortality — by 0.8% to 3.5% per year — occurred in Brazil, Egypt, Guatemala, Kuwait, Mauritius and Moldova.
The highest breast cancer death rates occurred in Barbados (26.1 deaths per 100,000 people), Armenia (24.2) and Ireland (19.7). The lowest death rates occurred in Guatemala (4.9), the Republic of Korea (5.2) and Egypt (5.9).
The researchers acknowledged that optimal breast cancer treatment is often not available in low-income countries. Further, they recognized social barriers in some countries, including cancer fatalism, the refusal or reluctance to have one’s breasts examined by a male doctor, and stigma associated with breast cancer and its treatment.
“Misconceptions about the nature or curability of breast cancer are still prevalent in many communities,” DeSantis and colleagues concluded. “Thus, it is necessary to increase awareness about breast cancer and the benefits of early detection, most notably in transitioning countries, in order to successfully implement breast cancer control programs, as well as to improve access to treatment.” – by Cameron Kelsall
Disclosure: The researchers report no relevant financial disclosures.
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