Wen Yeying, Ma Jingyu, Xiang Zhisheng, Lin Yongtian, Huang Yongying, Liu Linying, Zhou Yan, Sun Yang
Department of Epidemiology, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuzhou, Fujian, China.
Department of Gynecology, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuzhou, Fujian, China.
Cancer Med. 2025 Jul;14(13):e71033. doi: 10.1002/cam4.71033.
Breast cancer was the second most common cancer and the fifth leading cause of cancer deaths among women in China, with increasing trends. Evaluating breast cancer trends and predicting future burdens can inform prevention strategies. This study aimed to analyze the trends in female breast cancer incidence, mortality, and survival in Fujian Province, southeastern China, between 2011 and 2020, and to project the future burden through 2025.
Population-based cancer registry data from Fujian Province were collected during 2011-2020, with survival follow-up extending through March 2022, covering approximately 2.59 million women. Age-standardized incidence rates (ASIR) and mortality rates (ASMR) were calculated using Segi's world standard population. Temporal trends were assessed using Joinpoint regression analysis to determine average annual percentage change (AAPC). Relative survival were computed as the ratio of observed survival to expected survival. Autoregressive Integrated Moving Average (ARIMA) model was employed to predict incidence and mortality for 2021-2025.
During 2011-2020, 8047 female breast cancer cases and 1754 deaths were recorded. The ASIR increased from 19.34/100,000 to 38.73/100,000, with an AAPC of 7.4% (95% CI: 3.6%-11.4%). The ASMR increased from 3.37/100,000 to 6.19/100,000, with an AAPC of 8.3% (95% CI: 4.3%-12.4%). Rural areas showed more rapid increases in both incidence and mortality than in urban areas. In 2011-2014, 2015-2017, and 2018-2020, the age-standardized 5-year relative survival rates were 64.10% (95% CI: 59.85-68.02), 69.35% (95% CI: 64.62-73.57), and 72.94% (95% CI: 68.5-76.86), with higher survival in urban areas and younger age groups. The ARIMA models projected continued increases in both ASIR and ASMR through 2025, reaching 46.41/100,000 and 8.46/100,000, respectively.
Breast cancer constitutes an escalating public health challenge in Fujian Province with disparities across age groups and urban and rural areas. Future strategies should prioritize healthcare equity and regional resource allocation to reduce mortality and enhance survival outcomes.
乳腺癌是中国女性中第二大常见癌症，也是癌症死亡的第五大主要原因，且呈上升趋势。评估乳腺癌趋势并预测未来负担可为预防策略提供依据。本研究旨在分析2011年至2020年中国东南部福建省女性乳腺癌发病率、死亡率和生存率的趋势，并预测到2025年的未来负担。
收集了福建省2011 - 2020年基于人群的癌症登记数据，生存随访持续至2022年3月，覆盖约259万女性。使用Segi世界标准人口计算年龄标准化发病率（ASIR）和死亡率（ASMR）。采用Joinpoint回归分析评估时间趋势，以确定年均变化百分比（AAPC）。相对生存率计算为观察到的生存率与预期生存率之比。采用自回归积分移动平均（ARIMA）模型预测2021 - 2025年的发病率和死亡率。
2011 - 2020年期间，记录了8047例女性乳腺癌病例和1754例死亡。ASIR从19.34/10万增加到38.73/10万，AAPC为7.4%（95%CI：3.6% - 11.4%）。ASMR从3.37/10万增加到6.19/10万，AAPC为8.3%（95%CI：4.3% - 12.4%）。农村地区的发病率和死亡率增长速度均高于城市地区。在2011 - 2014年、2015 - 2017年和2018 - 2020年，年龄标准化的5年相对生存率分别为64.10%（95%CI：59.85 - 68.02）、69.35%（95%CI：64.62 - 73.57）和72.94%（95%CI：68.5 - 76.86），城市地区和较年轻年龄组的生存率更高。ARIMA模型预测到2025年ASIR和ASMR将持续上升，分别达到46.41/10万和8.46/10万。
乳腺癌对福建省的公共卫生构成了日益严峻的挑战，不同年龄组以及城乡之间存在差异。未来策略应优先考虑医疗公平和区域资源分配，以降低死亡率并提高生存结果。
