Projecting Future Diagnoses in Breast Cancer: Changing Demographic Patterns

Abstract

Breast cancer is the most common non-cutaneous cancer and the second leading cause of cancer-related death in females in the United States. As life expectancy and body mass index rise, increasing rates of breast cancer could have a large impact on the US healthcare system. Predicting the future incidence of breast cancer by demographics should help guide policy and practice efforts in order to inform future resource allocation. Population estimates were obtained by age, race, and ethnicity using 2010 US Census population projections. Breast cancer population-based incidence rates were obtained by age, race, and ethnicity using SEER 18 delay-adjusted data. Modeling was obtained assuming both a constant incidence rate as well as changes in age-adjusted, site-specific cancer incidence rates using an Average Annual Percent Change (AAPC) model using data from 2012-2016. These data were applied to our projection model to forecast diagnoses through 2040. Based on our two projection models, breast cancer incidence is expected to markedly increase over the coming two decades. Assuming a non-constant incidence rate (AAPC model), the annual breast cancer incidence is projected to increase by 31% between 2020 and 2040. This rise outpaces the projected increase in overall population of 12.3% across the same time period. The incidence of annual breast cancer diagnoses among nonwhite populations is estimated to increase by 36.8% by 2030 and 76.4% by 2040. In contrast, white Americans are projected to see a 14.0% and 20.2% rise by 2030 and 2040, respectively. In 2020, non-white females will make up only 19% of all new breast cancer diagnoses in the US, however by 2040 that percentage is expected to increase to 25% of all new breast cancer diagnoses. As the US population becomes more racially diverse, we can expect a growing proportion of our breast cancer patients to include nonwhite individuals. It is well known that African American and Hispanic females tend to be at risk for disparities in cancer care and survival. African American patients are more likely to do die from breast cancer at all ages. In light of this background, our findings underscore the need for multifaceted intervention to mitigate such inequities. A considerable expansion in breast cancer prevention and treatment infrastructure will be necessary to accommodate this increase. This insight should inform our research and practice efforts in the future.Tabled 1Abstract 2935; Table; Projected No. of Breast Cancer Diagnoses From 2020 to 2040 by RaceConstantAAPC 12-16WHITENONWHITEWHITENONWHITENo.% ΔNo.% ΔNo.% ΔNo.% Δ2020220955-49587-223586-53008-203024564611.176168724.4225470213.927249136.76204025677616.217303547.2926878020.219348476.36 Open table in a new tab