Division of Chronic Disease Epidemiology, Institute for Epidemiology, Biostatistics and Prevention, University of Zurich, Hirschengraben 82, 8001, Zurich, Switzerland.
Cancer Registry Zurich and Zug, University Hospital Zurich, Vogelsangstrasse 10, 8091, Zurich, Switzerland.
J Cancer Res Clin Oncol. 2019 Mar;145(3):653-660. doi: 10.1007/s00432-018-2822-2. Epub 2018 Dec 13.
Increase in in situ breast cancer (BCIS) incidence has been reported across Europe and the USA. However, little is known about the trends in BCIS incidence in regions without population-based mammographic screening programs. We set out to investigate these trends in Zurich, Switzerland, where only opportunistic mammographic screening exists.
Data from 989 women diagnosed with a primary BCIS between 2003 and 2014 were used in our analyses. Age-standardized incidence rates per 100,000 person-years (ASR) were computed per year. Additional analyses by BCIS subtype, by age group at diagnosis and by incidence period were conducted. Incidence trends over time were assessed using joinpoint regression analysis.
The overall BCIS ASR was 10.7 cases per 100,000 person-years with an increasing trend over the study period. A similar trend was observed for the ductal carcinoma in situ (DCIS) ASR, while the lobular carcinoma in situ (LCIS) ASR decreased. Age-specific analyses revealed that the 50-59 year age group had the highest BCIS ASR. The highest increase in BCIS ASR, even though not statistically significant, was observed for the < 40 year age group.
BCIS ASR increased linearly over a 12-year period. The increase was reflected by an increase in DCIS ASR, whereas LCIS ASR decreased over time. The highest increase in BCIS ASR over the study period was observed for the < 40 year age group, even though not statistically significant. Patient and tumor characteristics of this group that may be associated with BCIS development warrant further investigation.
据报道，欧洲和美国的原位乳腺癌（BCIS）发病率有所增加。然而，对于没有基于人群的乳房 X 线筛查计划的地区，BCIS 发病率的趋势知之甚少。我们着手研究瑞士苏黎世的这些趋势，那里只有机会性乳房 X 线筛查。
我们的分析使用了 2003 年至 2014 年间诊断出的 989 名原发性 BCIS 女性的数据。每年计算每 10 万人年（ASR）的标准化发病率。还按 BCIS 亚型、诊断时的年龄组和发病期进行了额外的分析。使用连接点回归分析评估随时间推移的发病率趋势。
总体 BCIS 的 ASR 为每 10 万人年 10.7 例，呈上升趋势。在研究期间，导管原位癌（DCIS）的 ASR 也观察到了类似的趋势，而小叶原位癌（LCIS）的 ASR 则下降。年龄特异性分析显示，50-59 岁年龄组的 BCIS ASR 最高。BCIS ASR 最高的增加，尽管没有统计学意义，是观察到的<40 岁年龄组。
BCIS ASR 在 12 年期间呈线性增加。DCIS ASR 的增加反映了这种增加，而 LCIS ASR 随时间推移而下降。在研究期间，BCIS ASR 的最高增加发生在<40 岁年龄组，尽管没有统计学意义。与 BCIS 发展相关的该组患者和肿瘤特征值得进一步研究。
