Catalan Cancer Plan, IDIBELL, Hospital Duran i Reynals, Av. Gran Via de l'Hospitalet, 199-203-1a planta, L'Hospitalet de Llobregat, 08908, Barcelona, Catalonia, Spain.
Department of Clinical Sciences, IDIBELL, University of Barcelona, L'Hospitalet de Llobregat, 08907, Barcelona, Spain.
Clin Transl Oncol. 2018 Mar;20(3):313-321. doi: 10.1007/s12094-017-1718-y. Epub 2017 Jul 19.
We assessed differences in predicted breast cancer (BC) mortality rates, across Europe, by 2020, taking into account changes in the time trends of BC mortality rates during the period 2000-2010.
BC mortality data, for 27 European Union (EU) countries, were extracted from the World Health Organization mortality database. First, we compared BC mortality data between time periods 2000-2004 and 2006-2010 through standardized mortality ratios (SMRs) and carrying out a graphical assessment of the age-specific rates. Second, making use of the base period 2006-2012, we predicted BC mortality rates by 2020. Finally, making use of the SMRs and the predicted data, we identified a clustering of countries, assessing differences in the time trends between the areas defined in this clustering.
The clustering approach identified two clusters of countries: the first cluster were countries where BC predicted mortality rates, in 2020, might slightly increase among women aged 69 and older compared with 2010 [Greece (SMR 1.01), Croatia (SMR 1.02), Latvia (SMR 1.15), Poland (SMR 1.14), Estonia (SMR 1.16), Bulgaria (SMR 1.13), Lithuania (SMR 1.03), Romania (SMR 1.13) and Slovakia (SMR 1.06)]. The second cluster was those countries where BC mortality rates level off or decrease in all age groups (remaining countries). However, BC mortality rates between these clusters might diminish and converge to similar figures by 2020.
For the year 2020, our predictions have shown a converging pattern of BC mortality rates between European regions. Reducing disparities, in access to screening and treatment, could have a substantial effect in countries where a non-decreasing trend in age-specific BC mortality rates has been predicted.
我们评估了 2020 年欧洲各国乳腺癌（BC）死亡率的差异，同时考虑了 2000-2010 年期间 BC 死亡率时间趋势的变化。
从世界卫生组织死亡率数据库中提取了 27 个欧盟（EU）国家的 BC 死亡率数据。首先，我们通过标准化死亡率比（SMR）比较了两个时间段（2000-2004 年和 2006-2010 年）的 BC 死亡率数据，并通过年龄特异性死亡率的图形评估进行了比较。其次，利用基础期 2006-2012 年，我们预测了 2020 年的 BC 死亡率。最后，利用 SMR 和预测数据，我们确定了国家聚类，并评估了在这种聚类定义的区域之间的时间趋势差异。
聚类方法确定了两个国家集群：第一个集群是 2020 年 69 岁及以上女性的 BC 预测死亡率可能会略有上升的国家，包括希腊（SMR 1.01）、克罗地亚（SMR 1.02）、拉脱维亚（SMR 1.15）、波兰（SMR 1.14）、爱沙尼亚（SMR 1.16）、保加利亚（SMR 1.13）、立陶宛（SMR 1.03）、罗马尼亚（SMR 1.13）和斯洛伐克（SMR 1.06）。第二个集群是所有年龄组的 BC 死亡率稳定或下降的国家。然而，到 2020 年，这些集群之间的 BC 死亡率可能会减少并趋同于相似的数值。
对于 2020 年，我们的预测显示欧洲各地区的 BC 死亡率呈现出趋同的模式。减少获得筛查和治疗的差距可能会对预测到特定年龄组 BC 死亡率呈非下降趋势的国家产生重大影响。
