Autier P, Boniol M, La Vecchia C, Vatten L, Gavin A, Hery C, Heanue MDisparities in breast cancer mortality trends between 30 European countries: retrospective trend analysis of WHO mortality database. BMJ 341: c3620

International Agency for Research on Cancer, Lyon, France.
BMJ (online) (Impact Factor: 17.45). 08/2010; 341(aug11 1):c3620. DOI: 10.1136/bmj.c3620
Source: PubMed


To examine changes in temporal trends in breast cancer mortality in women living in 30 European countries.
Retrospective trend analysis. Data source WHO mortality database on causes of deaths Subjects reviewed Female deaths from breast cancer from 1989 to 2006
Changes in breast cancer mortality for all women and by age group (<50, 50-69, and >or=70 years) calculated from linear regressions of log transformed, age adjusted death rates. Joinpoint analysis was used to identify the year when trends in all age mortality began to change.
From 1989 to 2006, there was a median reduction in breast cancer mortality of 19%, ranging from a 45% reduction in Iceland to a 17% increase in Romania. Breast cancer mortality decreased by >or=20% in 15 countries, and the reduction tended to be greater in countries with higher mortality in 1987-9. England and Wales, Northern Ireland, and Scotland had the second, third, and fourth largest decreases of 35%, 29%, and 30%, respectively. In France, Finland, and Sweden, mortality decreased by 11%, 12%, and 16%, respectively. In central European countries mortality did not decline or even increased during the period. Downward mortality trends usually started between 1988 and 1996, and the persistent reduction from 1999 to 2006 indicates that these trends may continue. The median changes in the age groups were -37% (range -76% to -14%) in women aged <50, -21% (-40% to 14%) in 50-69 year olds, and -2% (-42% to 80%) in >or=70 year olds.
Changes in breast cancer mortality after 1988 varied widely between European countries, and the UK is among the countries with the largest reductions. Women aged <50 years showed the greatest reductions in mortality, also in countries where screening at that age is uncommon. The increasing mortality in some central European countries reflects avoidable mortality.

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Available from: Mathieu Boniol, Feb 17, 2015
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    • "Breast cancer is a leading cause of death among women worldwide (Jemal et al, 2011). Breast cancer mortality has declined in western countries because of multidisciplinary efforts over the last decade, including improved detection through screening, increased specialisation of care (Kingsmore et al, 2003), and better access to more effective treatments, such as improved surgical techniques, targeted radiotherapy, and adjuvant therapies, including tamoxifen (Autier et al, 2010). Nevertheless, clinical outcomes in metastatic breast cancer (MBC) remain poor, and identification of therapeutics to improve treatment is necessary. "
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    British Journal of Cancer 02/2015; 112(5). DOI:10.1038/bjc.2015.10 · 4.84 Impact Factor
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    • "In the US the incidence has been stable over the last decade, although increasing almost everywhere throughout the world. Although breast cancer mortality is declining [1, 2], preventing breast cancer is the most effective way of reducing breast cancer death. Primary prevention focuses on preventing cancer from developing or delaying the development of a malignancy. "
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    • "Even considering these limitations, the profile of breast cancer mortality in Brazilian women follows a similar pattern that the one found worldwide. Therefore, although mortality in more developed regions, mainly in urban centers, shows a tendency towards decline or stabilization, as seen in the developed regions of North America and Europe [2] [8] [30], regarding the urban areas of Brazil, the present findings reveal disparities across all the regions of the country. On the other hand, in the great majority of rural areas, the coefficients of mortality have increased in the period, possibly due to poorer access to the healthcare system, while incidence rates have increased as a result of changes in lifestyle such as a reduction in physical activity, declining fertility, aging population, changes in reproductive patterns and obesity [31]. "
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