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. 2021 Jul 7:38:100985.
doi: 10.1016/j.eclinm.2021.100985. eCollection 2021 Aug.

Global breast cancer incidence and mortality trends by region, age-groups, and fertility patterns

Sarah M Lima  1   2 , Rebecca D Kehm  1 , Mary Beth Terry  1   2
Affiliations

Global breast cancer incidence and mortality trends by region, age-groups, and fertility patterns

Sarah M Lima et al. EClinicalMedicine. .

Abstract

Background: Breast cancer (BC) has been increasing globally, though it is unclear whether the increases are seen across all age groups and regions and whether changes in rates can be primarily attributed to decreasing fertility rates. We investigated age-specific trends in BC incidence and mortality from 1990 to 2017, worldwide and by region, and evaluated whether incidence trends are explained by decreases in fertility.

Methods: We used country-level data to examine trends in BC incidence and mortality rates from 1990 to 2017 by region and age group. Linear mixed models were used to estimate age-specific rates from baseline models of year and were compared to fertility-adjusted models for incidence.

Results: The global BC mortality rate increased overall by 0.23% per year (95% CI=0.20, 0.25), with statistically significant increases in the under 50 and 70 and over age groups, and in 5 out of 7 regions. The global BC incidence rate increased overall by 1.44% per year (95% CI=1.42, 1.47), with statistically significant increases in all age groups, and in 6 out of 7 regions. After adjusting for fertility, the incidence annual percent change (APC) remained statistically significant (APC=0.84, 95% CI=0.81, 0.88), in all age groups, and in 6 of 7 regions.

Interpretation: The global increase in BC mortality is seen in most age groups and regions. The global increase in BC incidence is seen in all age groups and is highest in women under 50; increases remained in most regions even after considering declining fertility rates.

Funding: Breast Cancer Research Foundation and National Cancer Institute.

Keywords: Breast cancer; Fertility; Global; Incidence rate; Mortality rate.

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Conflict of interest statement

Dr. Terry has nothing to disclose.

Figures

Fig. 1
Fig. 1
Temporal trends in breast cancer incidence and mortality rates, age-standardized (all ages) and in women under 50 years, by world region. (A) Age-standardized incidence rates (all ages), by region. (B) Incidence rates for women under 50, by region. (C) Age-standardized mortality rates (all ages), by region. (D) Mortality rates for women under 50, by region.
Fig. 2
Fig. 2
Annual percent change in breast cancer incidence compared against absolute breast cancer incidence rate in 2017 and total fertility rate in 2007 for each country, grouped by world region, overall (age-standardized) and in women under 50. APC = annual percent change. Y-axis: incidence rate (per 100,000) in 2017; X-axis: APC from 1990 to 2017. The three left panels, (A), (B) and (C), show the APC, incidence rates and fertility rates for overall age; the three right panels, (D), (E), and (F), show the APC, incidence rates, and fertility rates for women under 50 years. The top panels, (A) and (D), show APCs of the time-trend, base model and incidence rates; the middle panels, (B) and (E), show APCs from the fertility-adjusted model and incidence rates; and the bottom panels (C) and (F), show APCs from the fertility-adjusted model and total fertility rates.
See this image and copyright information in PMC

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