Katalinic Alexander, Pritzkuleit Ron, Waldmann Annika
Institut für Krebsepidemiologie e.V., Universität zu Lübeck, Germany.
Breast Care (Basel). 2009;4(2):75-80. doi: 10.1159/000211526. Epub 2009 Apr 24.
BACKGROUND: Breast cancer is the most common cancer among women in Germany with high public health impact. In the last decade rapid changes in risk factor patterns, early breast cancer detection, and therapy have taken place. Their effects on breast cancer epidemiology in Germany are described. MATERIALS AND METHODS: A register-based survey using recent incidence data from German cancer registries was performed. Mortality data were provided by the Central Federal Statistical Office. We calculated age-standardized rates and 5- and 10-year trends. RESULTS: Breast cancer incidence increased until the year 2002, thereafter a discreet decline occurred until 2005 (-6.8%). In the age group 50-59 years this reduction was most pronounced (-12%). Mortality declined from 1996/7 to 2004/5 by 19%, with the strongest effect in women younger than 55 years (approximately 30%). Regional patterns of breast cancer incidence and mortality revealed differences within Germany of greater than 30%. CONCLUSION: Declining hormone replacement therapy prescription is the most likely factor to explain the drop in breast cancer incidence. The reduction in mortality might be caused by better therapy and enhanced early detection during the last decade. Differences in breast cancer incidence and mortality between Eastern and Western Germany give reason for further research and discussion.
背景：乳腺癌是德国女性中最常见的癌症，对公众健康有重大影响。在过去十年中，风险因素模式、早期乳腺癌检测和治疗发生了迅速变化。本文描述了这些变化对德国乳腺癌流行病学的影响。材料与方法：利用德国癌症登记处的最新发病数据进行了基于登记的调查。死亡率数据由联邦中央统计局提供。我们计算了年龄标准化率以及5年和10年趋势。结果：乳腺癌发病率在2002年之前上升，此后直至2005年出现轻微下降（-6.8%）。在50 - 59岁年龄组中，这种下降最为明显（-12%）。死亡率从1996/7年至2004/5年下降了19%，对55岁以下女性的影响最为显著（约30%）。乳腺癌发病率和死亡率的区域模式显示德国境内差异超过30%。结论：激素替代疗法处方的减少是解释乳腺癌发病率下降的最可能因素。死亡率的降低可能是由于过去十年中治疗的改善和早期检测的加强。德国东部和西部乳腺癌发病率和死亡率的差异为进一步研究和讨论提供了理由。
