Abstract
To analyze time-dependent changes in female breast cancer (BC) mortality in China, forecast the trend in the ensuing 5 years, and provide recommendations for prevention and management. Mortality data of breast cancer in China from 1991 to 2011 was used to describe characteristics and distribution, such as the changes of the standardized mortality rate, urban-rural differences and age differences. Trend-surface analysis was used to study the geographical distribution of mortality. In addition, curve estimation, time series modeling, Gray modeling (GM) and joinpoint regression were performed to estimate and predict future trends. In China, the mortality rate of breast cancer has increased yearly since 1991. In addition, our data predicted that the trend will continue to increase in the ensuing 5 years. Rates in urban areas are higher than those in rural areas. Over the past decade, all peak ages for death by breast cancer have been delayed, with the first death peak occurring at 55 to 65 years of age in urban and rural areas. Geographical analysis indicated that mortality rates increased from Southwest to Northeast and from West to East. The standardized mortality rate of breast cancer in China is rising and the upward trend is predicted to continue for the next 5 years. Since this can cause an enormous health impact in China, much better prevention and management of breast cancer is needed. Consequently, disease control centers in China should place more focus on the northeastern, eastern and southeastern parts of China for breast cancer prevention and management, and the key population should be among women between ages 55 to 65, especially those in urban communities.
Highlights
Breast cancer is by far the most frequent cancer among women with an estimated 1.38 million new cancer cases diagnosed in 2008 (23% of all cancers) (Ferlay et al, 2010)
Many epidemiological studies report that breast cancer mortality rates have been increasing, especially in developing countries
Based on the increased mortality rate among Chinese women in recent decades, it can be found that breast cancer is the second leading cancer-related cause of death among women
Summary
Breast cancer is by far the most frequent cancer among women with an estimated 1.38 million new cancer cases diagnosed in 2008 (23% of all cancers) (Ferlay et al, 2010). The mortality of breast cancer has increased markedly in Chinese women during the past decade. Many epidemiological studies report that breast cancer mortality rates have been increasing, especially in developing countries. These studies mainly describe incidence and mortality rates, and trends for breast cancer by population (race/ethnicity), location, age and calendar time (Franco et al, 2009; Lazcano et al, 2009; Lopez et al, 2009; Curado et al, 2011). Prediction of the trends and identification of geographic patterns of breast cancer mortality, based on population and location, may provide impetus to conduct further investigations and can direct health resources for the development of more useful prevention and management policies
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