Abstract:
BACKGROUND:In 2003, for the first time, US breast cancer incidence rates have fallen. Experts argue whether this is due to the reduced uptake of screening mammography or to lower use of Hormone Replacement Therapy (HRT). This study aims to disentangle the respective impact of screening and HRT on age-incidence rates and histology of breast cancer, by comparing two populations with comparably high levels of screening mammography, but with different prevalence of HRT. METHODS:We included all invasive breast cancers recorded at the Geneva cancer registry (n = 4,909) and the Netherlands Cancer Registry (n = 152,428) between 1989-2003. We compared age-specific incidence rates and trends in histological subtyping between the two populations. RESULTS:Between 1989-1991, incidence rates increased with age in both populations. In 2001-2003, women aged 60-64 years showed highest incidence rates in Geneva, while in the Netherlands incidence rates continued to increase with age. The annual increase in ductal cancer incidence was similar in the Netherlands (2.3%) and Geneva (2.5%), but the annual increase in lobular cancer was sharper in Geneva (10%) than in the Netherlands (5%). CONCLUSION:The sharp differences in age distribution and histological subtyping of breast cancer between two European populations are not attributable to screening, since both populations have a high uptake of mammography screening. Since the prevalence of HRT use is very high in Geneva and rather low in the Netherlands, HRT may explain these discrepancies. However, other etiological factors and differences in histological assessment may also have played a role.
journal_name
Breast Cancer Res Treatjournal_title
Breast cancer research and treatmentauthors
Verkooijen HM,Koot VC,Fioretta G,van der Heiden M,Schipper ME,Rapiti E,Peeters PH,Peterse JL,Bouchardy Cdoi
10.1007/s10549-007-9554-3subject
Has Abstractpub_date
2008-02-01 00:00:00pages
389-95issue
3eissn
0167-6806issn
1573-7217journal_volume
107pub_type
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