Abstract
BackgroundA gradual decline in the incidence of breast cancer is documented in developed countries especially over last two decades, while in developing countries the incidence continues to rise. We conducted this study to examine trends in incidence of breast cancer in a developing country, Sri Lanka.MethodsA retrospective cohort evaluation of patients with breast cancer during 2001–2010 was performed using population based data from the Sri Lanka National Cancer Registry. Trends in incidence were analysed using Joinpoint regression analysis.ResultsThe age standardized incidence of female breast cancer in Sri Lanka appears to have increased from 17.3 per 100,000 in 2001 (95% confidence interval [95% CI] 16.5–18.2) to 24.7 per 100,000 in 2010 (95% CI 23.7–25.7); a 1.4-fold increase (p < 0.05) with an estimated annual percentage change (EAPC) of 4.4 (95% CI 3.3–5.5). Highest incidence of breast cancer was seen among women of 60 to 64-year age group which has increased from 68.1 to 100.2 per 100,000 over this period (EAPC 4.6%, 95% CI 3.9–5.2, p < 0.001 for trend). A substantially greater increase was observed among women older than 50 years (from 50.4 to 76.9 per 100,000; EAPC 5.5, 95% CI 4.1–7.0, p < 0.05) compared with women younger than 50 years (from 32.0 to 39.6 per 100,000; EAPC 2.3, 95% CI 1.1–3.5, p < 0.05).ConclusionsA gradual but a significant increase in the incidence of female breast cancer is observed in Sri Lanka. A rapid rise in the breast cancer incidence among post-menopausal women appears to be the major contributor towards this increase. Improving cancer data collection appears to have been a contributor to the observed increase. However, an inherent increase is also likely as differential rates of increase were observed by age groups. Further research is needed to identify the reasons for the observed increase which may help with future cancer control efforts in Sri Lanka.
Highlights
A gradual decline in the incidence of breast cancer is documented in developed countries especially over last two decades, while in developing countries the incidence continues to rise
The highest incidence of female breast cancer was seen in 60–64 age group (70.3 per 100,000 population), while the highest incidence of male breast cancer was seen in over 75+ year age group (3.38 per 100,000 population) (Fig. 1)
The estimated annual percentage change (EAPC) for overall female age standardized incidence rate was 4.4 which was similar to the overall EAPC rate
Summary
A gradual decline in the incidence of breast cancer is documented in developed countries especially over last two decades, while in developing countries the incidence continues to rise. The same has contributed to an increase in Fernando et al BMC Cancer (2018) 18:482 the incidence of breast cancer as many cancers which otherwise would not have manifested clinically, are diagnosed through screening [8]. Many developing countries including Sri Lanka does not have a national breast cancer screening programme. This probably is one reason for the higher proportion of advanced breast cancers at diagnosis observed in Sri Lanka, compared with developed countries [9]. Lack of a national screening programme has likely contributed to the lower breast cancer incidence in Sri Lanka compared with the developed countries
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
