Breast cancer incidence and mortality in women in China: temporal trends and projections to 2030

Abstract

Objective: Breast cancer was the most common cancer and the fifth cause of cancer deaths among women in China in 2015. The evaluation of the long-term incidence and mortality trends and the prediction of the future burden of breast cancer could provide valuable information for developing prevention and control strategies.

Methods: The burden of breast cancer in China in 2015 was estimated by using qualified data from 368 cancer registries from the National Central Cancer Registry. Incident cases and deaths in 22 cancer registries were used to assess the time trends from 2000 to 2015. A Bayesian age-period-cohort model was used to project the burden of breast cancer to 2030.

Results: Approximately 303,600 new cases of breast cancer (205,100 from urban areas and 98,500 from rural areas) and 70,400 breast cancer deaths (45,100 from urban areas and 24,500 from rural areas) occurred in China in 2015. Urban regions of China had the highest incidence and mortality rates. The most common histological subtype of breast cancer was invasive ductal carcinoma, followed by invasive lobular carcinoma. The age-standardized incidence and mortality rates increased by 3.3% and 1.0% per year during 2000-2015, and were projected to increase by more than 11% until 2030. Changes in risk and demographic factors between 2015 and 2030 in cases are predicted to increase by approximately 13.3% and 22.9%, whereas deaths are predicted to increase by 13.1% and 40.9%, respectively.

Conclusions: The incidence and mortality of breast cancer continue to increase in China. There are no signs that this trend will stop by 2030, particularly in rural areas. Effective breast cancer prevention strategies are therefore urgently needed in China.

Keywords: Breast cancer; China; cancer registry; prediction; temporal trends.

Figure 1

Distribution of histological subtypes of breast cancer in 2015.

Figure 2

Breast cancer incidence trends by histological subtype during 2008–2015.

Figure 3

Trends in age-specific incidence and mortality rates during 2000–2015 and predictions from 2016 to 2030 in China. (A) Total incidence; (B) urban incidence; (C) rural incidence; (D) total mortality; (E) urban mortality; (F) rural mortality.

Figure 4

The total increased breast cancer cases and deaths between 2015 and 2030 in China. (A) Total cases; (B) urban cases; (C) rural cases; (D) total deaths; (E) urban deaths; (F) rural deaths; the blue line represents predicted cancer cases or deaths from 2015 to 2030; the black line represents estimated numbers of total breast cancer cases or deaths by application of the 2015 age-specific incidence or mortality rate.