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. 2023 Apr 14;5(15):340-346.
doi: 10.46234/ccdcw2023.065.

Trends in Incidence Rates, Mortality Rates, and Age-Period-Cohort Effects of Female Breast Cancer - China, 2003-2017

Kexin Sun  1 , Lin Lei  2 , Rongshou Zheng  1 , Siwei Zhang  1 , Hongmei Zeng  1 , Shaoming Wang  1 , Li Li  1 , Ru Chen  1 , Bingfeng Han  1 , Ji Peng  2 , Wenqiang Wei  1 , Jie He  3
Affiliations

Trends in Incidence Rates, Mortality Rates, and Age-Period-Cohort Effects of Female Breast Cancer - China, 2003-2017

Kexin Sun et al. China CDC Wkly. .

Abstract

Introduction: This study reported the trends in female breast cancer incidence and mortality rates in China, and analyzed the corresponding age-period-cohort effects.

Methods: Data from 22 population-based cancer registries in China between 2003 and 2017 were analyzed. Age-standardized incidence rates (ASIR) and mortality rates (ASMR) were calculated using Segi's world standard population. Joinpoint regression was employed to evaluate trends, and age-period-cohort effects were examined using the intrinsic estimator method.

Results: The ASIR for female breast cancer exhibited a more rapid increase in rural areas compared to urban areas across all age groups. The most substantial increase was observed in the 20-34 age group in rural areas [annual percent change (APC)=9.0%, 95% confidence interval (CI): 7.0%-11.0%, P<0.001]. The ASMR for females under 50 years old remained stable from 2003 to 2017 in both urban and rural areas. However, the ASMR for females over 50 in rural areas and those over 65 in urban areas demonstrated a significant increase, with the most pronounced increase observed among females over 65 in rural areas (APC=4.9%, 95% CI: 2.8%-7.0%, P<0.001). Age-period-cohort analysis revealed increasing period effects and decreasing cohort effects for female breast cancer incidence and mortality rates in both urban and rural settings. Notably, the cohort effect for incidence displayed a slight upward trend for females born between 1983 and 1992 in rural areas.

Conclusions: Our study revealed a rapid increase in breast cancer incidence among younger generations and an accelerated mortality rate in older populations residing in rural areas. To effectively address the growing burden of female breast cancer in China, it is essential to develop and implement targeted intervention strategies.

Keywords: Age-period-cohort; Breast Cancer; Female; Incidence; Mortality.

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Figures

Figure 1
Figure 1
Trends in incidence and mortality rates of female breast cancer by age group and area, 2003–2017. (A) Incidence rates across all areas. (B) Incidence rates in urban settings. (C) Incidence rates in rural settings. (D) Mortality rates across all areas. (E) Mortality rates in urban settings. (F) Mortality rates in rural settings.
Figure 2
Figure 2
The age-specific incidence and mortality rates of female breast cancer, by time period and area. (A) Incidence rates in all areas. (B) Incidence rates in urban areas. (C) Incidence rates in rural areas. (D) Mortality rates in all areas. (E) Mortality rates in urban areas. (F) Mortality rates in rural areas.
Figure 3
Figure 3
The birth cohort-specific incidence and mortality rates of female breast cancer, by area. (A) Incidence rates in urban areas. (B) Incidence rates in rural areas. (C) Mortality rates in urban areas. (D) Mortality rates in rural areas. Results were not shown in age group 20–24 if the age-specific rate is 0.
Figure 4
Figure 4
The result of age-period-cohort analysis of incidence and mortality rates of female breast cancer, by area. (A) Incidence rates in urban areas. (B) Incidence rates in rural areas. (C) Mortality rates in urban areas. (D) Mortality rates in rural areas. ote：Blue solid and dash lines represent the age effect and 95% confidence interval. Orange solid and dash lines represent the period effect and 95% confidence interval. Pink solid and dash lines represent the cohort effect and 95% confidence interval.
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References

    1. Zheng RS, Zhang SW, Zeng HM, Wang SM, Sun KX, Chen R, et al Cancer incidence and mortality in China, 2016. J Natl Cancer Cent. 2022;2(1):1–9. doi: 10.1016/j.jncc.2022.02.002. - DOI - PMC - PubMed
    1. Lima SM, Kehm RD, Terry MB Global breast cancer incidence and mortality trends by region, age-groups, and fertility patterns. EClinicalMedicine. 2021;38:100985. doi: 10.1016/j.eclinm.2021.100985. - DOI - PMC - PubMed
    1. Heer E, Harper A, Escandor N, Sung H, McCormack V, Fidler-Benaoudia MM Global burden and trends in premenopausal and postmenopausal breast cancer: a population-based study. Lancet Glob Health. 2020;8(8):e1027–37. doi: 10.1016/s2214-109x(20)30215-1. - DOI - PubMed
    1. Lei SY, Zheng RS, Zhang SW, Chen R, Wang SM, Sun KX, et al Breast cancer incidence and mortality in women in China: temporal trends and projections to 2030. Cancer Biol Med. 2021;18(3):900–9. doi: 10.20892/j.issn.2095-3941.2020.0523. - DOI - PMC - PubMed
    1. Li N, Deng YJ, Zhou LH, Tian T, Yang S, Wu Y, et al Global burden of breast cancer and attributable risk factors in 195 countries and territories, from 1990 to 2017: results from the Global Burden of Disease Study 2017. J Hematol Oncol. 2019;12(1):140. doi: 10.1186/s13045-019-0828-0. - DOI - PMC - PubMed

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