Die Brustkrebsmortalität der Frauen in den Kreisen Schleswig-Holsteins von 1981 bis 1995

Abstract

The present descriptive study evaluates breast cancer mortality among women in the northernmost German Federal State of Schleswig-Holstein over the period from 1981 to 1995 based on data provided by the Schleswig-Holstein State Office for Statistics. Starting from the results of the second Cancer Atlas for the Federal Republic of Germany [11], covering the period 1976-1980, breast cancer mortality rates rose sharply until the beginning of our investigation. A moderate rise in breast-cancer mortality in Schleswig-Holstein continued until the third period under investigation (1987-1989), while after that time breast cancer mortality decreased again towards the end of the investigation period. In Schleswig-Holstein as a whole, the mortality rate increased by approximately 12% during the last 20 years. When reviewing age-specific breast-cancer mortality for each rural district ('Kreis') or, respectively, for each self-administrative town (kreisfreie Stadt), different patterns were observed, particularly among younger women. In the 40- to 44-year and 45- to 49-year age group a rise in breast cancer mortality was observed in several, but not all districts. Mortality patterns do not tend to be representative for breast cancer incidence because mortality reflects only a small proportion of the women actually suffering from breast cancer. The standardised incidence of breast cancer in Germany--calculated on the basis of data provided by the Saarland cancer registry--is currently over 60/100,000 and is thus 2-3 times the mortality rate. However, presently it is not possible to evaluate the breast cancer incidence (Schleswig-Holstein) because the first population-based cancer registration was initiated only in 1999. In contrast to other German Federal States, notification of all cancer cases is compulsory in Schleswig-Holstein. A valid analysis of breast cancer incidence should be possible in 5-10 years conditional on a registration rate of at least 90%. Further investigations into the causes of breast cancer should be carried out to test specific hypotheses on exposure to risk factors, including nutrition and life style to clarify the regional differences observed in this study.