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Divergent Patterns and Trends in Breast Cancer Incidence, Mortality and Survival Among Older Women in Germany and the United States

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 i...

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Autores principales: Jansen, Lina, Holleczek, Bernd, Kraywinkel, Klaus, Weberpals, Janick, Schröder, Chloé Charlotte, Eberle, Andrea, Emrich, Katharina, Kajüter, Hiltraud, Katalinic, Alexander, Kieschke, Joachim, Nennecke, Alice, Sirri, Eunice, Heil, Jörg, Schneeweiss, Andreas, Brenner, Hermann
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7565138/
https://www.ncbi.nlm.nih.gov/pubmed/32858964
http://dx.doi.org/10.3390/cancers12092419
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author Jansen, Lina
Holleczek, Bernd
Kraywinkel, Klaus
Weberpals, Janick
Schröder, Chloé Charlotte
Eberle, Andrea
Emrich, Katharina
Kajüter, Hiltraud
Katalinic, Alexander
Kieschke, Joachim
Nennecke, Alice
Sirri, Eunice
Heil, Jörg
Schneeweiss, Andreas
Brenner, Hermann
author_facet Jansen, Lina
Holleczek, Bernd
Kraywinkel, Klaus
Weberpals, Janick
Schröder, Chloé Charlotte
Eberle, Andrea
Emrich, Katharina
Kajüter, Hiltraud
Katalinic, Alexander
Kieschke, Joachim
Nennecke, Alice
Sirri, Eunice
Heil, Jörg
Schneeweiss, Andreas
Brenner, Hermann
author_sort Jansen, Lina
collection PubMed
description 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 (1975–2015), shifts in stage distributions (1998–2015), and trends in five-year relative survival (1979–2015) were estimated. Additionally, trends in five-year relative survival after standardization for stage were explored (2004–2015). 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 1979–1983 and 2013–2015 in Germany (+17% units) and the US (+19% units) but was 9% units lower in German patients aged 70+ years in 2013–2015. 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.
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spelling pubmed-75651382020-10-26 Divergent Patterns and Trends in Breast Cancer Incidence, Mortality and Survival Among Older Women in Germany and the United States Jansen, Lina Holleczek, Bernd Kraywinkel, Klaus Weberpals, Janick Schröder, Chloé Charlotte Eberle, Andrea Emrich, Katharina Kajüter, Hiltraud Katalinic, Alexander Kieschke, Joachim Nennecke, Alice Sirri, Eunice Heil, Jörg Schneeweiss, Andreas Brenner, Hermann Cancers (Basel) Article 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 (1975–2015), shifts in stage distributions (1998–2015), and trends in five-year relative survival (1979–2015) were estimated. Additionally, trends in five-year relative survival after standardization for stage were explored (2004–2015). 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 1979–1983 and 2013–2015 in Germany (+17% units) and the US (+19% units) but was 9% units lower in German patients aged 70+ years in 2013–2015. 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. MDPI 2020-08-26 /pmc/articles/PMC7565138/ /pubmed/32858964 http://dx.doi.org/10.3390/cancers12092419 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Jansen, Lina
Holleczek, Bernd
Kraywinkel, Klaus
Weberpals, Janick
Schröder, Chloé Charlotte
Eberle, Andrea
Emrich, Katharina
Kajüter, Hiltraud
Katalinic, Alexander
Kieschke, Joachim
Nennecke, Alice
Sirri, Eunice
Heil, Jörg
Schneeweiss, Andreas
Brenner, Hermann
Divergent Patterns and Trends in Breast Cancer Incidence, Mortality and Survival Among Older Women in Germany and the United States
title Divergent Patterns and Trends in Breast Cancer Incidence, Mortality and Survival Among Older Women in Germany and the United States
title_full Divergent Patterns and Trends in Breast Cancer Incidence, Mortality and Survival Among Older Women in Germany and the United States
title_fullStr Divergent Patterns and Trends in Breast Cancer Incidence, Mortality and Survival Among Older Women in Germany and the United States
title_full_unstemmed Divergent Patterns and Trends in Breast Cancer Incidence, Mortality and Survival Among Older Women in Germany and the United States
title_short Divergent Patterns and Trends in Breast Cancer Incidence, Mortality and Survival Among Older Women in Germany and the United States
title_sort divergent patterns and trends in breast cancer incidence, mortality and survival among older women in germany and the united states
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7565138/
https://www.ncbi.nlm.nih.gov/pubmed/32858964
http://dx.doi.org/10.3390/cancers12092419
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