Recent changes in breast cancer incidence in Spain, 1980-2004

BACKGROUND: Since the 1980s, Spain experienced two decades of sharply increasing breast cancer incidence. Declines in breast cancer incidence have recently been reported in many developed countries. We examined whether a similar downturn might have taken place in Spain in recent years. METHODS: Case...

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Detalhes bibliográficos
Autores: Pollan-Santamaria, Marina, Pastor-Barriuso, Roberto, Ardanaz, Eva, Argüelles, Marcial, Martos, Carmen, Galcerán, Jaume, Sánchez-Pérez, María-José, Chirlaque, María-Dolores, Larrañaga, Nerea, Martínez-Cobo, Ruth, Tobalina, María-Cres, Vidal, Enric, Marcos-Gragera, Rafael, Mateos, Antonio, Garau, Isabel, Rojas-Martín, María-Dolores, Jiménez, Rosario, Torrella-Ramos, Ana, Perucha, Josefina, Pérez-de-Rada, Maria-Eugenia, González, Susana, Rabanaque, María-José, Borràs, Joan, Navarro, Carmen, Hernández, Esther, Izquierdo, Angel, Lopez-Abente, Gonzalo, Martínez, Carmen
Tipo de documento: artigo
Data de publicação:2009
País:España
Recursos:Instituto de Salud Carlos III (ISCIII)
Repositório:Repisalud
Idioma:inglês
OAI Identifier:oai:repisalud.isciii.es:20.500.12105/6811
Acesso em linha:http://hdl.handle.net/20.500.12105/6811
Access Level:Acceso aberto
Palavra-chave:Adult
Age Factors
Age of Onset
Aged
Descrição
Resumo:BACKGROUND: Since the 1980s, Spain experienced two decades of sharply increasing breast cancer incidence. Declines in breast cancer incidence have recently been reported in many developed countries. We examined whether a similar downturn might have taken place in Spain in recent years. METHODS: Cases of invasive female breast cancer were drawn from all population-based Spanish cancer registries that had at least 10 years of uninterrupted registration over the period 1980-2004. Overall and age-specific changes in incidence rates were evaluated using change-point Poisson models, which allow for accurate detection and estimation of trend changes. All statistical tests were two-sided. RESULTS: A total of 80,453 incident cases of invasive breast cancer were identified. Overall age- and registry-adjusted incidence rates rose by 2.9% (95% confidence interval [CI] = 2.7% to 3.1%) annually during the 1980s and 1990s; there was a statistically significant change in this trend in 2001 (95% CI = 1998 to 2004; P value for the existence of a change point <.001), after which incidence declined annually by 3.0% (95% CI = 1.8% to 4.1%). This trend differed by age group: There was a steady increase in incidence for women younger than 45 years, an abrupt downturn in 2001 for women aged 45-64 years, and a gradual leveling off in 1995 for women aged 65 years or older. Separate analyses for registries that had at least 15 years of uninterrupted registration detected a statistically significant interruption of the previous upward trend in breast cancer incidence in provinces that had aggressive breast cancer screening programs and high screening participation rates, including Navarra (change point = 1991, P < .001), Granada (change point = 2002, P = .003), Bizkaia (change point = 1998, P < .001), Gipuzkoa (change point = 1998, P = .001), and Araba (change point = 1997, P = .002). CONCLUSIONS: The recent downturn in breast cancer incidence among Spanish women older than 45 years is best explained by a period effect linked to screening saturation.

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