Skip to main content

Advertisement

Log in

Breast cancer incidence trends in European women aged 20–39 years at diagnosis

  • Epidemiology
  • Published:
Breast Cancer Research and Treatment Aims and scope Submit manuscript

Abstract

An increase in the incidence of breast cancer in women aged <40 years has been reported in recent years. Increased incidence could be partly explained by subtle detection biases, but the role of other risk factors cannot be ruled out. The purpose of the present study was to investigate the changes in temporal trends in breast cancer incidence in European women aged 20–39 years at diagnosis. Age specific breast cancer incidence rates for 17 European Cancer Registries were retrieved for the calendar period 1995–2006. Cancer registries data were pooled to reduce annual fluctuations present in single registries and increase incidence rates stability. Regression models were fitted to the data assuming that the number of cancer cases followed the Poisson distribution. Mean annual changes in the incidence rate (AIC) across the considered time window were calculated. The AIC estimated from all European registries was 1.032 (95 % CI = 1.019–1.045) and 1.014 (95 % CI = 1.010–1.018) in women aged 20–29 and 30–39 years old at diagnosis, respectively. The major change was detected among women aged 25–29 years at diagnosis: AIC = 1.033 (95 % CI = 1.020–1.046). The upward trend was not affected when registries with high or low AIC were removed from the analysis (sensitivity analysis). Our findings support the presence of an increase in the incidence of breast cancer in European women in their 20s and 30s during the decade 1995–2006. The interpretation of the observed increase is not straightforward since a number of factors may have affected our results. The estimated annual increase in breast cancer incidence may result in a burden of the disease that is important in terms of public health and deserves further investigation of possible risk factors.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Cancer incidence in five continents. Volume VIII (2000) IARC Sci Publ 155:1–781

    Google Scholar 

  2. Ferlay J, Autier P, Boniol M, Heanue M, Colombet M, Boyle P (2007) Estimates of the cancer incidence and mortality in Europe in 2006. Ann Oncol 18:581–592

    Article  PubMed  CAS  Google Scholar 

  3. Karim-Kos HE, de VE, Soerjomataram I, Lemmens V, Siesling S, Coebergh JW (2008) Recent trends of cancer in Europe: a combined approach of incidence, survival and mortality for 17 cancer sites since the 1990s. Eur J Cancer 44:1345–1389

  4. Jatoi I, Anderson WF, Rao SR, Devesa SS (2005) Breast cancer trends among black and white women in the United States. J Clin Oncol 23:7836–7841

    Article  PubMed  Google Scholar 

  5. Fuglede N, Langballe O, Svendsen AL, Tjonneland A, Dalton SO, Johansen C (2006) Development in incidence of breast cancer in non-screened Danish women, 1973–2002: a population-based study. Int J Cancer 118:2366–2369

    Article  PubMed  CAS  Google Scholar 

  6. Otten JD, Broeders MJ, Fracheboud J, Otto SJ, de Koning HJ, Verbeek AL (2008) Impressive time-related influence of the Dutch screening programme on breast cancer incidence and mortality, 1975–2006. Int J Cancer 123:1929–1934

    Article  PubMed  CAS  Google Scholar 

  7. Jemal A, Ward E, Thun MJ (2007) Recent trends in breast cancer incidence rates by age and tumor characteristics among U.S. women. Breast Cancer Res 9:R28

    Article  PubMed  Google Scholar 

  8. Ravdin PM, Cronin KA, Howlader N, Berg CD, Chlebowski RT, Feuer EJ, Edwards BK, Berry DA (2007) The decrease in breast-cancer incidence in 2003 in the United States. N Engl J Med 356:1670–1674

    Article  PubMed  CAS  Google Scholar 

  9. Katalinic A, Rawal R (2008) Decline in breast cancer incidence after decrease in utilisation of hormone replacement therapy. Breast Cancer Res Treat 107:427–430

    Article  PubMed  CAS  Google Scholar 

  10. Kumle M (2008) Declining breast cancer incidence and decreased HRT use. Lancet 372:608–610

    Article  PubMed  Google Scholar 

  11. Allemand H, Seradour B, Weill A, Ricordeau P (2008) Decline in breast cancer incidence in 2005 and 2006 in France: a paradoxical trend. Bull Cancer 95:11–15

    PubMed  Google Scholar 

  12. Ponti A, Rosso S, Zanetti R, Ricceri F, Tomatis M, Segnan N (2007) Re: Breast cancer incidence, 1980–2006: combined roles of menopausal hormone therapy, screening mammography, and estrogen receptor status. J Natl Cancer Inst 99:1817–1818

    Article  PubMed  Google Scholar 

  13. Kumle M, Weiderpass E, Braaten T, Persson I, Adami HO, Lund E (2002) Use of oral contraceptives and breast cancer risk: the Norwegian–Swedish women’s lifestyle and health cohort study. Cancer Epidemiol Biomarkers Prev 11:1375–1381

    PubMed  CAS  Google Scholar 

  14. Louwman WJ, Voogd AC, van Dijck JA, Nieuwenhuijzen GA, Ribot J, Pruijt JF, Coebergh JW (2008) On the rising trends of incidence and prognosis for breast cancer patients diagnosed 1975–2004: a long-term population-based study in southeastern Netherlands. Cancer Causes Control 19:97–106

    Article  PubMed  CAS  Google Scholar 

  15. Bouchardy C, Fioretta G, Verkooijen HM, Vlastos G, Schaefer P, Delaloye JF, Neyroud-Caspar I, Balmer MS, Wespi Y, Forni M et al (2007) Recent increase of breast cancer incidence among women under the age of forty. Br J Cancer 96:1743–1746

    Article  PubMed  CAS  Google Scholar 

  16. Brinton LA, Sherman ME, Carreon JD, Anderson WF (2008) Recent trends in breast cancer among younger women in the United States. J Natl Cancer Inst 100:1643–1648

    Article  PubMed  Google Scholar 

  17. Engholm G, Ferlay J, Christensen N, Bray F, Gjerstorff ML, Klint A, Kotlum JE, Olafsdottir E, Pukkala E, Storm HH (2010) NORDCAN: a Nordic tool for cancer information, planning, quality control and research. Acta Oncol 49:725–736

    Article  PubMed  Google Scholar 

  18. Lindsey JK (1995) Modelling frequency and count data. Oxford University Press, Oxford

    Google Scholar 

  19. Leyland AH, Goldstein H (2001) Multilevel modelling of health statistics. Wiley, Chichester

  20. Cleveland WS, Devlin SJ (1988) Locally-weighted regression: an approach to regression analysis by local fitting. J Am Stat Assoc 83:596–610

    Google Scholar 

  21. Stata statistical sofware (Release 11) (2009) StataCorp LP, College Station

  22. Kelsey JL, Gammon MD (1991) The epidemiology of breast cancer. CA Cancer J Clin 41:146–165

    Article  PubMed  CAS  Google Scholar 

  23. Hery C, Ferlay J, Boniol M, Autier P (2008) Quantification of changes in breast cancer incidence and mortality since 1990 in 35 countries with Caucasian-majority populations. Ann Oncol 19:1187–1194

    Article  PubMed  CAS  Google Scholar 

  24. Colonna M, Delafosse P, Uhry Z, Poncet F, Arveux P, Molinie F, Cherie-Challine L, Grosclaude P (2008) Is breast cancer incidence increasing among young women? An analysis of the trend in France for the period 1983–2002. Breast 17:289–292

    Article  PubMed  Google Scholar 

  25. IARC handbooks of cancer prevention: volume 7. Breast Cancer Screening (2002) IARC Sci Publ 1–14

  26. Seradour B, Allemand H, Weill A, Ricordeau P (2009) Changes by age in breast cancer incidence, mammography screening and hormone therapy use in France from 2000 to 2006. Bull Cancer 96:E1–E6

    PubMed  CAS  Google Scholar 

  27. Li CI, Daling JR (2007) Changes in breast cancer incidence rates in the United States by histologic subtype and race/ethnicity, 1995 to 2004. Cancer Epidemiol Biomarkers Prev 16:2773–2780

    Article  PubMed  Google Scholar 

  28. Parkin DM (2009) Is the recent fall in incidence of post-menopausal breast cancer in UK related to changes in use of hormone replacement therapy? Eur J Cancer 45:1649–1653

    Article  PubMed  Google Scholar 

  29. Pollan M, Michelena MJ, Ardanaz E, Izquierdo A, Sanchez-Perez MJ, Torrella A (2010) Breast cancer incidence in Spain before, during and after the implementation of screening programmes. Ann Oncol 21(Suppl 3): iii97–iii102

    Google Scholar 

  30. Glass AG, Lacey JV Jr, Carreon JD, Hoover RN (2007) Breast cancer incidence, 1980–2006: combined roles of menopausal hormone therapy, screening mammography, and estrogen receptor status. J Natl Cancer Inst 99:1152–1161

    Article  PubMed  Google Scholar 

  31. Anders CK, Johnson R, Litton J, Phillips M, Bleyer A (2009) Breast cancer before age 40 years. Semin Oncol 36:237–249

    Article  PubMed  Google Scholar 

  32. Han W, Kang SY (2010) Relationship between age at diagnosis and outcome of premenopausal breast cancer: age less than 35 years is a reasonable cut-off for defining young age-onset breast cancer. Breast Cancer Res Treat 119:193–200

    Article  PubMed  Google Scholar 

  33. Levi F, Te VC, Maspoli M, Randimbison L, Bulliard JL, La Vecchia C (2007) Trends in breast cancer incidence among women under the age of forty. Br J Cancer 97:1013–1014

    PubMed  CAS  Google Scholar 

  34. Cancer Incidence in Belgium, 2004–2005, Belgian Cancer Registry, Brussels (2008). www.coldfusionwebhostings.be/PSK/Upload/GENERAL//Brochures/KIB2004-2005/CancerInc_book.pdf. Accessed 26 Jan 2012

  35. Hunter DJ, Colditz GA, Hankinson SE, Malspeis S, Spiegelman D, Chen W, Stampfer MJ, Willett WC (2010) Oral contraceptive use and breast cancer: a prospective study of young women. Cancer Epidemiol Biomarkers Prev 19(10): 2496–2502

    Google Scholar 

  36. Gabriel CA, Domchek SM (2010) Breast cancer in young women. Breast Cancer Res 12:212

    Article  PubMed  Google Scholar 

  37. Yankaskas BC (2005) Epidemiology of breast cancer in young women. Breast Dis 23:3–8

    PubMed  Google Scholar 

  38. Pollan M (2010) Epidemiology of breast cancer in young women. Breast Cancer Res Treat 123(Suppl 1):3–6

    Article  PubMed  Google Scholar 

  39. Colditz GA, Sellers TA, Trapido E (2006) Epidemiology: identifying the causes and preventability of cancer? Nat Rev Cancer 6:75–83

    Article  PubMed  CAS  Google Scholar 

  40. Ruder EH, Dorgan JF, Kranz S, Kris-Etherton PM, Hartman TJ (2008) Examining breast cancer growth and lifestyle risk factors: early life, childhood, and adolescence. Clin Breast Cancer 8:334–342

    Article  PubMed  Google Scholar 

  41. Screening for breast cancer: U.S. Preventive Services Task Force recommendation statement (2009) Ann Intern Med 151: 236–716

Download references

Acknowledgments

Dr. Luigina Bonelli, Prevenzione Secondaria e Screening, IRCCS AOU San Martino-IST-Istituto Nazionale per la Ricerca sul Cancro, Genova, Italy, for valuable comments.

Conflict of interest

The authors declare that they have no conflict of interest.

Author information

Authors and Affiliations

Authors

Consortia

Corresponding author

Correspondence to D. F. Merlo.

Additional information

The members of AIRTUM Working Group are given in Appendix.

Appendix

Appendix

M. Federico, Registro Tumori di Modena, Italy; L. Mangone, Registro Tumori Reggiano, Italy; M. Michiara, Registro Tumori della Provincia di Parma, Italy; M. Fusco, Registro Tumori di Napoli, Italy; E. Crocetti, Banca dati AIRTUM, Unità Operativa di Epidemiologia Clinica e Descrittiva, ISPO, Italy.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Merlo, D.F., Ceppi, M., Filiberti, R. et al. Breast cancer incidence trends in European women aged 20–39 years at diagnosis. Breast Cancer Res Treat 134, 363–370 (2012). https://doi.org/10.1007/s10549-012-2031-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10549-012-2031-7

Keywords

Navigation