OBJECTIVETo describe the current status of mortality breast cancer in Chinese females between 2004 and 2005, as well as its developing trend from 1973 to 2005.

METHODSThe data of female breast cancer deaths and number of female under exposure were collected through the Third National Mortality Retrospective Sampling Survey, which covered a total of 69 690 241 person years of females. The data was descriptively analyzed, and compared with the data of time-trend of breast cancer mortality in the previous two surveys in 1973 - 1975 and 1990 - 1992 respectively.

RESULTSThe crude mortality of female breast cancer in China in 2004 - 2005 was 5.90 per 100 000 (4112/69 690 241), ranking the sixth most common cancer death in Chinese females, and accounted for 5.90% (4112/69 667) of all female deaths from cancer. The crude mortality of female breast cancer was 6.86/100 000 (1777/25 900 856) in the eastern China, 5.91/100 000 (1431/24 225 738) in the central China and 4.62/100 000 (904/19 563 647) in the western China. The age-standardized mortality among Chinese standard population of female breast cancer in urban area (4.91/100 000, 1899 death cases) was 1.44 times higher than that in rural area (3.42/100 000, 2213 death cases). The crude mortality increased 99.99% from 1973 - 1975 (2.95/100 000) to 2004 - 2005 (5.90/100 000), the absolute figure increased by 2.95/100 000. The age-standardized mortality among Chinese standard population increased 37.85% from 1973 - 2005 (2.88/100 000) to 2004 - 2005 (3.97/100 000), the absolute figure increased 1.09/100 000.

CONCLUSIONThe mortality of female breast cancer in urban area was higher than that in rural area, and it decreased from the eastern China, to the central China and to the western China in turn. The mortality of female breast cancer has constantly increased in China since 1973.

Age Distribution ; Breast Neoplasms ; epidemiology ; mortality ; China ; epidemiology ; Female ; Humans

OBJECTIVENationwide cancer incidence data were used to analyze the trends of cancer incidence in China in order to provide basic information for making cancer control strategy.

METHODSWe retrieved and re-sorted valid cancer incidence data from the National Central Cancer Registry Database over the 20 year-period 1989-2008. Crude incidence rate and age-standardized incidence rate were calculated for analysis. Annual percent changes in incidence for all cancers combined were estimated using Joinpoint software.

RESULTSThe cancer incidence rate in cancer registration areas was increased from 184.81/10(5) in 1989 to 286.69/10(5) in 2008 (from 209.33/10(5) to 307.04/10(5) in urban and from 176.10/10(5) to 269.57/10(5) in rural areas). Uptrends of crude cancer incidence were shown in both male and female in urban and rural areas over the 20 year-period. After standardized by age, overall incidence rate kept stable with 0.5% annual increase in urban and no change in rural areas. Since 2000, the cancer incidences in both sexes and areas were significantly increased. The incidence increased for most major cancers, especially lung cancer, colorectal cancer, female breast cancer and cervical cancer.

CONCLUSIONSOver the 20 year-period 1989-2008, cancer incidence of most cancers has been increasing by time. The incidences of gastric cancer, liver cancer and esophageal cancer still keep gradually increasing. The incidences of lung cancer, female breast cancer, colorectal cancer and cervical cancer are markedly going up, so that cancer prevention and control should be enhanced. Cancer registration will play an important role on cancer control in China along with the number of registries increasing and data quality improving.

Breast Neoplasms ; epidemiology ; China ; epidemiology ; Colorectal Neoplasms ; epidemiology ; Esophageal Neoplasms ; epidemiology ; Female ; Humans ; Incidence ; Liver Neoplasms ; epidemiology ; Lung Neoplasms ; epidemiology ; Male ; Neoplasms ; epidemiology ; Registries ; Rural Population ; Stomach Neoplasms ; epidemiology ; Urban Population ; Uterine Cervical Neoplasms ; epidemiology

PURPOSE: There has been an increasing trend in the use of contralateral prophylactic mastectomy (CPM) among women diagnosed with unilateral breast cancer or mutations in BRCA1 or BRCA2 to reduce the occurrence of contralateral breast cancer. This study aimed to examine trends in the CPM rate according to clinicopathologic and socioeconomic status at a single institution in Korea. METHODS: This study included 128 patients with mutations in BRCA1 or BRCA2. Patients were divided into a CPM group (n = 8) and a non-CPM group (n = 120) between May 2013 and March 2016. The main outcome variables, including epidemiology, clinical features, socioeconomic status, and tumor characteristics, were analyzed. RESULTS: A total of 8 CPMs were performed among 128 patients. All CPM patients were married. The proportion of professional working women was higher in the CPM group (P = 0.049). Most patients who underwent CPM graduated college, compared to less than a third of the non-CPM group (P = 0.013). The CPM group had a higher rate of visits to the Hereditary Breast and Ovarian Cancer (HBOC) clinic (P = 0.021). The risk-reducing salpingo-oophorectomy (RRSO) rate was significantly higher in the CPM group (P < 0.01). CONCLUSION: CPM rates were significantly different according to socioeconomic status. The CPM rate tends to increase in highly educated and professional working women. The socioeconomic status of patients is an important factor in the decision to participate in the HBOC clinic and undergo CPM or RRSO.
Breast ; Breast Neoplasms ; Epidemiology ; Female ; Humans ; Korea ; Mastectomy ; Ovarian Neoplasms ; Social Class ; Unilateral Breast Neoplasms ; Women, Working

Breast Neoplasms ; epidemiology ; China ; epidemiology ; Female ; Humans ; Occupational Diseases ; epidemiology ; Risk Factors ; Stress, Psychological

Objective: To analyze the trends of incidence and age change for global female breast cancer in different regions of the world according to the database from Cancer Incidence in Five Continents Time Trends (CI5plus) published by the International Association of Cancer Registries (IACR). Methods: The recorded annual female breast cancer (ICD-10: C50) incidence data and corresponding population at-risk data (1998-2012) were extracted from CI5plus published by IACR. The annual change percentage and average annual change percentage (AAPC) were calculated to examine the trends of incidence. The age-standardized mean age at diagnosis and proportion of incidence cases by age were calculated to analyze the relationship between incidence and age. Results: For crude incidence, except in Northern America, all other regions showed an upward trend, with Asia showing the most obvious upward trend (AAPC: 4.1%, 95% CI: 3.9%, 4.3%). For age-standardized incidence, in Asia, Latin America and Europe, the rising trends had slowed down, in Oceania and Africa, the trends began to be stable, and in Northern America, the trend showed a downward trend (APPC: -0.6%; 95% CI: -1.0%, -0.1%). The mean age at diagnosis were increased from 1998 to 2012 in Asia, Latin America, Oceania and Europe, with an annual increase of 0.12 years, 0.09 years, 0.04 years and 0.03 years, respectively. But after age-standardized, only Europe still kept increasing year by year, with an annual increase of 0.02 years, while Northern America showed a decreasing trend, with an annual decrease of about 0.03 years. Conclusions: From 1998 to 2012, the trends of incidence and age change for global female breast cancer vary in different regions of the world, and the global population aging is widespread, which affects the trend of the actual age change. Prevention and control strategies should be targeted at different age groups in different regions.
Humans ; Female ; Breast Neoplasms/epidemiology* ; Incidence ; Asia/epidemiology* ; Europe/epidemiology* ; Risk Factors

OBJECTIVETo explore the application of counter-matching design in epidemiological research.

METHODSThrough elaboration of the study about gene-environment interactions in the etiology of breast cancer, methodology regarding counter-matching design and statistic methods was introduced.

RESULTSThis design improved the potential for detecting gene-environment interactions for diseases when both gene mutations and the environmental exposures of interest were rare in the general population.

CONCLUSIONCounter-matching appearsed to be more appropriate than most traditional epidemiologic methods for the study of interactions involving rare factors.

Breast Neoplasms ; epidemiology ; etiology ; genetics ; radiotherapy ; Epidemiologic Methods ; Humans ; Male

BACKGROUND: The cancer burden in the United States of America (USA) has decreased gradually. However, China is experiencing a transition in its cancer profiles, with greater incidence of cancers that were previously more common in the USA. This study compared the latest cancer profiles, trends, and determinants between China and USA. METHODS: This was a comparative study using open-source data. Cancer cases and deaths in 2022 were calculated using cancer estimates from GLOBOCAN 2020 and population estimates from the United Nations. Trends in cancer incidence and mortality rates in the USA used data from the Surveillance, Epidemiology, and End Results program and National Center for Health Statistics. Chinese data were obtained from cancer registry reports. Data from the Global Burden of Disease 2019 and a decomposition method were used to express cancer deaths as the product of four determinant factors. RESULTS: In 2022, there will be approximately 4,820,000 and 2,370,000 new cancer cases, and 3,210,000 and 640,000 cancer deaths in China and the USA, respectively. The most common cancers are lung cancer in China and breast cancer in the USA, and lung cancer is the leading cause of cancer death in both. Age-standardized incidence and mortality rates for lung cancer and colorectal cancer in the USA have decreased significantly recently, but rates of liver cancer have increased slightly. Rates of stomach, liver, and esophageal cancer decreased gradually in China, but rates have increased for colorectal cancer in the whole population, prostate cancer in men, and other seven cancer types in women. Increases in adult population size and population aging were major determinants for incremental cancer deaths, and case-fatality rates contributed to reduced cancer deaths in both countries. CONCLUSIONS The decreasing cancer burden in liver, stomach, and esophagus, and increasing burden in lung, colorectum, breast, and prostate, mean that cancer profiles in China and the USA are converging. Population aging is a growing determinant of incremental cancer burden. Progress in cancer prevention and care in the USA, and measures to actively respond to population aging, may help China to reduce the cancer burden.
Adult ; Breast Neoplasms ; China/epidemiology* ; Female ; Humans ; Incidence ; Liver Neoplasms ; Male ; Neoplasms/epidemiology* ; Registries ; United States/epidemiology*

Breast Neoplasms ; complications ; epidemiology ; Eye Neoplasms ; diagnosis ; epidemiology ; secondary ; Female ; Humans

OBJECTIVETo estimate the association between overweight, obesity and the risk of breast cancer in Chinese female population.

METHODSLiteratures published in China and abroad about overweight, obesity and breast cancer risk among Chinese females were searched. We used "breast cancer", "overweight", "obesity", "weight", "body mass index" and "risk factors" as keywords, to retrieve papers in Chinese literature databases including CNKI, Wanfang and Weipu database. The same strategy was used to retrieve English papers in English literature database including Embase database, PubMed, Science Direct, Elsevier and Cochrane database, supplemented by literature tracing method. Time range was from the founding of each database to April 2012. A total of 124 research papers were collected. Using Stata11.2 software, meta-analysis was conducted, combined odds ratio (OR) and 95% confidence interval (CI) were calculated to estimate the associations between overweight, obesity and the risk of breast cancer in Chinese female population.

RESULTSEighteen studies were included in meta-analysis, among them 12 studies were in Chinese and 6 were in English, with a number of 7217 cases and 81 605 controls. Results showed a 7.7% increased risk of breast cancer among overweight or obesity women (OR = 1.08, 95%CI: 1.04 - 1.12). Compared with normal BMI women, the OR (95%CI) of overweight or obesity women were 1.07 (1.03 - 1.11) and 1.56 (1.29 - 1.84) before and after the adjustment of menopausal status.

CONCLUSIONOverweight, obesity may be important risk factors of breast cancer in Chinese female population. The intervention and control activities may reduce the risk of breast cancer at population level.

Asian Continental Ancestry Group ; Breast Neoplasms ; epidemiology ; China ; epidemiology ; Female ; Humans ; Obesity ; epidemiology ; Overweight ; epidemiology ; Risk Factors

OBJECTIVE: To analyze participant factors that affect the diagnostic performance of screening mammography. MATERIALS AND METHODS: We enrolled 128756 cases from 10 hospitals between 2005 and 2010. We analyzed recall rate, cancer detection rate (CDR) per 1000 examinations, positive predictive value (PPV), sensitivity, specificity, false positive rate (FPR), and interval cancer rate (ICR) per 1000 negative examinations according to participant factors including age, breast density, and number of visit to the same institution, and adjusted for confounding variables. RESULTS: Increasing age improved recall rates (27.4% in 40's, 17.5% in 50's, 11.1% in 60's, and 8.6% in 70's), CDR (2.7, 3.2, 2.0, and 2.4), PPV (1.0, 1.8, 1.8, and 2.8%), sensitivity (81.3, 88.8, 90.3, and 94.7%), specificity (72.7, 82.7, 89.0, and 91.7%), and FPR (27.3, 17.3, 11.0, and 8.4%) (p < 0.05). Higher breast density impaired recall rates (4.0% in P1, 9.0% in P2, 28.9% in P3, and 27.8% in P4), PPV (3.3, 2.3, 1.2, and 1.3%), specificity (96.1, 91.2, 71.4, and 72.5%), and FPR (3.9, 8.9, 28.6, and 27.6%) (p < 0.001). It also increased CDR (1.3, 2.1, 3.3, and 3.6) and ICR (0.2, 0.3, 0.6, and 1.6) (p < 0.05). Successive visits to the same institution improved recall rates (20.9% for one visit, 10.7% for two visits, 7.7% for more than three visits), PPV (1.6, 2.8, and 2.7%), specificity (79.4, 89.6, and 92.5%), and FPR (20.6, 10.4, and 7.5%) (p < 0.001). CONCLUSION: Young age and dense breasts negatively affected diagnostic performance in mammography screening, whereas successive visits to the same institution had a positive effect. Examinee education for successive visits to the same institution would improve the diagnostic performance.
Breast Neoplasms* ; Breast* ; Confounding Factors (Epidemiology) ; Education ; Korea* ; Mammography* ; Mass Screening* ; Sensitivity and Specificity