Original articleTrends and predictions to 2020 in breast cancer mortality in Europe
Introduction
After long term rises, breast cancer mortality has been declining in most of Europe since the mid or late 1980's [1]. The declines were earlier and larger in northern Europe, where breast cancer rates were originally highest [2], [3]. This led to a levelling of breast cancer mortality across Europe, although substantial differences were still evident; among major countries overall mortality rates were between 21/100,000 women in Denmark and 12.8 in Spain around 2007 [4], [5]. The favourable trend in breast cancer mortality over the last few decades is essentially due to advancement in diagnosis and treatment which have steadily accumulated over this period, though incidence has declined in recent generations as well [6], [7].
To provide an updated and comprehensive picture of recent trends and patterns in breast cancer mortality across Europe, we considered the most recent mortality data (up to 2014 in most countries) and provided predictions to 2020 [8] for select larger European countries and the whole European Union (EU).
Section snippets
Materials and methods
We retrieved official death certification data for breast cancer from the World Health Organization (WHO) database [9], from 1970 to 2014 (or the most recent available year), for European countries.
In some countries, data were missing for one or more calendar years. We did not extrapolate missing data, except for the calculation of the EU rates, where we used the nearest available data, for the few missing data in single countries. We considered the EU as defined on May 2017, i.e. including 28
Results
Table 1 gives the age-standardized mortality rates from breast cancer at all ages and at ages 20–49, 50–69 and 70–79 years for 36 European countries and the EU as a whole around 2002 (2000–2004 quinquiennium), 2007 (2005–2009 quinquiennium) and 2012 (single year), with the percent changes between 2012 and 2002.
Overall EU breast cancer mortality rates declined from 17.9 in 2002 to 15.2 per 100,000 in 2012 (−15.3%). All major EU countries showed favourable trends, and the percent changes ranged
Discussion
The present analysis confirms and extends the continuing favourable trends in breast cancer mortality registered across Europe over the last three decades [4], [18]. In some countries, such as the UK and other northern European countries, which had the highest rates in the past [2], the decline has reached 50%. The UK is predicted to have the second lowest cancer mortality rate in 2020. The falls were smaller, and inconsistent, in eastern Europe, which, for unclear reasons, had the lowest rates
Funding
This work was supported by the Italian Association for Cancer Research (AIRC, project N. 18440); MIUR (Ministero dell'Istruzione, dell'Università e della Ricerca), with a SIR (Scientific Independence of Young Researchers) 2014 grant (project N. RBSI1465UH).
Conflicts of interest
None.
Ethical approval
The approval of the journal on ethical consent and the standards of animal care is not required.
Acknowledgments
The authors acknowledge Dr Iman Elsayed for her assistance to data analysis.
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