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Divergent Patterns and Trends in Breast Cancer Incidence, Mortality and Survival Among Older Women in Germany and the United States
- Source :
- Cancers, 12(9):2419, Cancers, Vol 12, Iss 2419, p 2419 (2020), Cancers, Volume 12, Issue 9
- Publication Year :
- 2020
- Publisher :
- MDPI AG, 2020.
-
Abstract
- Background: Breast cancer treatment has changed tremendously over the last decades. In addition, the use of mammography screening for early detection has increased strongly. To evaluate the impact of these developments, long-term trends in incidence, mortality, stage distribution and survival were investigated for Germany and the United States (US). Methods: Using population-based cancer registry data, long-term incidence and mortality trends (1975&ndash<br />2015), shifts in stage distributions (1998&ndash<br />2015), and trends in five-year relative survival (1979&ndash<br />2015) were estimated. Additionally, trends in five-year relative survival after standardization for stage were explored (2004&ndash<br />2015). Results: Age-standardized breast cancer incidence rates were much higher in the US than in Germany in all periods, whereas age-standardized mortality began to lower in the US from the 1990s on. The largest and increasing differences were observed for patients aged 70+ years with a 19% lower incidence but 45% higher mortality in Germany in 2015. For this age group, large differences in stage distributions were observed, with 29% (Germany) compared to 15% (US) stage III and IV patients. Age-standardized five-year relative survival increased strongly between 1979&ndash<br />1983 and 2013&ndash<br />2015 in Germany (+17% units) and the US (+19% units) but was 9% units lower in German patients aged 70+ years in 2013&ndash<br />2015. This difference was entirely explained by differences in stage distributions. Conclusions: Overall, our results are in line with a later uptake and less extensive utilization of mammography screening in Germany. Further studies and efforts are highly needed to further explore and overcome the increased breast cancer mortality among elderly women in Germany.
- Subjects :
- trends
Cancer Research
United States
Survival
Trends
Mortality
Incidence
Breast cancer
Germany
Breast cancer mortality
Population
survival
lcsh:RC254-282
Article
03 medical and health sciences
breast cancer
0302 clinical medicine
Medicine
030212 general & internal medicine
Stage (cooking)
Mortality trends
education
education.field_of_study
Relative survival
business.industry
Incidence (epidemiology)
lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens
medicine.disease
mortality
Cancer registry
Oncology
030220 oncology & carcinogenesis
incidence
business
Demography
Subjects
Details
- ISSN :
- 20726694
- Volume :
- 12
- Database :
- OpenAIRE
- Journal :
- Cancers
- Accession number :
- edsair.doi.dedup.....40c8085cdf4e54316478cfb4b826b8fb