Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy.
Navarra Health Service, Pamplona, Spain.
Breast. 2017 Dec;36:89-95. doi: 10.1016/j.breast.2017.06.003. Epub 2017 Oct 4.
We analyzed trends in mortality from breast cancer in women in 36 European countries and the European Union (EU) over the period 1970-2014, and predicted numbers of deaths and rates to 2020.
We derived breast cancer death certification data and population figures from the World Health Organization and Eurostat databases. We obtained 2020 estimates using a joinpoint regression model.
Overall, EU breast cancer mortality rates (world standard) declined from 17.9/100,000 in 2002 to 15.2 in 2012. The predicted 2020 rate is 13.4/100,000. The falls were largest in young women (20-49 years, -22% between 2002 and 2012). Within the EU, declines were larger in the United Kingdom (UK) and other northern and western European countries than in most central and eastern Europe. The UK has the second lowest predicted breast cancer mortality rate in 2020 (after Spain), starting from the highest one in 1970. Breast cancer mortality is predicted to rise in Poland, where the predicted 2020 rate is 15.3/100,000. We estimated that about 32,500 breast cancer deaths will be avoided in 2020 in the EU as compared to the peak rate of 1989, and a total of 475,000 breast cancer deaths over the period 1990-2020.
The overall favourable breast cancer mortality trends are mainly due to a succession of improvements in the management and treatment of breast cancer, though early diagnosis and screening played a role, too. Improving breast cancer management in central and eastern Europe is a priority.
我们分析了 1970 年至 2014 年期间,36 个欧洲国家和欧盟(EU)女性乳腺癌死亡率的趋势,并预测了 2020 年的死亡人数和死亡率。
我们从世界卫生组织和欧盟统计局数据库中获取了乳腺癌死亡证明数据和人口数据。我们使用连接点回归模型获得了 2020 年的估计值。
总体而言,欧盟乳腺癌死亡率(世界标准)从 2002 年的 17.9/100,000 下降到 2012 年的 15.2。预计 2020 年的死亡率为 13.4/100,000。下降幅度最大的是年轻女性(20-49 岁,2002 年至 2012 年下降了 22%)。在欧盟内部,英国(英国)和其他北欧和西欧国家的降幅大于大多数中东欧国家。英国在 2020 年的乳腺癌死亡率预测最低(仅次于西班牙),而其在 1970 年的乳腺癌死亡率最高。波兰的乳腺癌死亡率预计将上升,其 2020 年的预测死亡率为 15.3/100,000。我们估计,与 1989 年的峰值相比,2020 年欧盟将避免约 32500 例乳腺癌死亡,而在 1990 年至 2020 年期间,将总共发生 475000 例乳腺癌死亡。
乳腺癌死亡率的总体有利趋势主要归因于乳腺癌管理和治疗的一系列改进,尽管早期诊断和筛查也发挥了作用。改善中东欧的乳腺癌管理是当务之急。