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Trends in incidence and mortality of female breast cancer during transition in Central China

Authors Cheng Y, Yan Y, Gong J, Yang N, Nie S

Received 13 August 2018

Accepted for publication 10 October 2018

Published 23 November 2018 Volume 2018:10 Pages 6247—6255

DOI https://doi.org/10.2147/CMAR.S182510

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Andrew Yee

Peer reviewer comments 2

Editor who approved publication: Professor Nakshatri


Yao Cheng,1 Yaqiong Yan,2 Jie Gong,2,* Niannian Yang,2,* Shaofa Nie1,*

1Department of Epidemiology and Biostatistics, Ministry of Education Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; 2Department of Chronic Disease Prevention and Control, Wuhan Centers for Disease Prevention and Control, Wuhan, China

*These authors contributed equally to this work

Purpose: Following the implementation of breast cancer (BC) control strategies for years in Central China, the outcome needs to be evaluated and further strategies based on long-term surveillance should be formulated. Therefore, we examined the trends of BC incidence and mortality during 1990–2014 and projected them to 2024 in Wuhan, Central China.
Patients and methods: The incidence and mortality data of BC were extracted from the Wuhan Cancer Registry. The average annual percentage changes (AAPCs) of the age-standardized incidence rate (ASIR) and age-standardized mortality rate (ASMR) were analyzed using Joinpoint regression. The Nordpred R-package was used to project BC incidence and mortality between 2015 and 2024. The age–period–cohort analysis was applied to evaluate the age, period, and cohort effects on the trends of BC incidence and mortality.
Results: Overall, the ASIR increased markedly from 20.01 to 44.26 per 100,000 (AAPC=3.3%, 95% CI: 1.7%, 5.0%) during 1990–2014, and it was projected to keep increasing in the next decade (AAPC=3.0%, 95% CI: 2.0%, 4.1%). The ASMR of BC leveled off during the study period (AAPC=0.4%, 95% CI: −0.2%, 0.9%). The BC mortality of the older group (aged 50–79 years) showed significant upward trends in both observed and projected periods. Strong age, period, and cohort effects were observed in BC incidence, and BC mortality was significantly driven by age and cohort effects.
Conclusion: The ASIR in Wuhan was approaching those areas with the highest BC risk in China, and the evident increase in BC incidence suggested that prior strategies for BC control should be adopted. In particular, further strategies for reducing BC mortality in older age groups should be reinforced in Wuhan, Central China.

Keywords: breast cancer, incidence, mortality, trend, rate projection

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