Breast cancer incidence and case fatality among 4.7 million women in relation to social and ethnic background: a population-based cohort study

Abstract

IntroductionIncidence of breast cancer is increasing around the world and it is still the leading cause of cancer mortality in low- and middle-income countries. We utilized Swedish nationwide registers to study breast cancer incidence and case fatality to disentangle the effect of socioeconomic position (SEP) and immigration from the trends in native Swedes.MethodsA nation-wide cohort of women in Sweden was followed between 1961 and 2007 and incidence rate ratio (IRR) and hazard ratio (HR) with 95% confidence intervals (CIs) were estimated using Poisson and Cox proportional regression models, respectively.ResultsIncidence continued to increase; however, it remained lower among immigrants (IRR = 0.88, 95% CI = 0.86 to 0.90) but not among immigrants' daughters (IRR = 0.97, 95% CI = 0.94 to 1.01) compared to native Swedes. Case fatality decreased over the last decades and was similar in native Swedes and immigrants. However, case fatality was significantly 14% higher if cancer was diagnosed after age 50 and 20% higher if cancer was diagnosed in the most recent years among immigrants compared with native Swedes. Women with the highest SEP had significantly 20% to 30% higher incidence but had 30% to 40% lower case fatality compared with women with the lowest SEP irrespective of country of birth. Age at immigration and duration of residence significantly modified the incidence and case fatality.ConclusionsDisparities found in case fatality among immigrants by age, duration of residence, age at immigration and country of birth emphasize the importance of targeting interventions on women that are not likely to attend screenings or are not likely to adhere to the therapy suggested by physicians. The lower risk of breast cancer among immigrant women calls for more knowledge about how the lifestyle factors in these women differ from those with high risk, so that preventative measures may be implemented.

Sobrevida por câncer de mama e iniquidade em saúde

“…In the USA, this association was also evidenced in both cohort studies 25,26 and clinical trials 27 . Major studies conducted in European countries, some with national registries of the entire population, have also shown better prognosis for breast cancer in women with higher socioeconomic status 28,29,30 . Finally, such association is also found in countries with lower development levels 31,32,33 .…”

Update knowledge on cervical cancer incidence and prevalence in Asia

“…Similar difference in occurrence of cervical cancer in developing and developed countries was reported in Asia in 1970. Incidence of cervical cancer is high in Korea, Japan and India (Beiki et al, 2012). Incidence of cervical cancer in Turkey is 4.4%.…”

Meta-analysis of Psychological Interventions on Breast Cancer Patients' Immune Function

“…Only one study examined the effectiveness of various psychological interventions for enhancing immune function [22]. Breast cancer is the most common tumor among women worldwide, and the incidence has been increasing since the 1970s [24]. However, we are aware of no study that has specifically addressed the effectiveness of psychological intervention in breast cancer patients' immune functioning.…”