Epidemiology and survival outcome of breast cancer in a nationwide study

Abstract

Breast cancer is among the most prevalent cancers in Taiwan. The National Health Insurance database was used to identify patients with breast cancer and estimate the yearly prevalence and incidence of breast cancer between 1997 and 2013. Joinpoint regression analysis was used for the annual percentage change of incidence, prevalence, and survival outcome. Among 12,181,919 female beneficiaries in 2013, the prevalence was 834.37 per 100,000 persons (95% confidence interval, 829.28–839.45) and the incidence was 93.00 per 100,000 person-year (95% confidence interval, 91.27–94.73). The average annual percentage change of the age-standardized breast cancer incidence was 3.5 per 100,000 person-years (3.1–3.8; P < 0.05), suggesting an increase in breast cancer incidence over the study period. The 5-year mortality rate was 4.5% in 1997 and 4.4% in 2008. The 5-year mortality rate among patients with Charlson comorbidity index > 1 was 39.1% (19.2%–59.1%) in 1997 and 21.1% (15.7%-32.0%) in 2008, with an annual percentage change of –0.8 (–1.3 to 2.9), suggesting that the mortality rate was gradually decreasing in patients with comorbidities. In conclusion, 1 in 120 women in Taiwan has breast cancer and the incidence is rising, while the annual percentage change of breast cancer prevalence is decreasing. The mortality rate of breast cancer was essentially stable, but the 1-year, 2-year, and 5-year mortality rates in people with Charlson comorbidity index > 1 were declined.

Risperidone Exposure and Breast Cancer Risk: A Cohort Study Using the Taiwan National Health Insurance Research Database

“…In 2013, the estimated incidence of BC in Taiwan was 93 per 100,000 person-years [3]. Our study found that the incidence of BC among women having antipsychotics was 30%-70% higher than that reported in the general population.…”

“…Age is a well-recognized risk factor for BC [22], and we observed differences in the age Research Frank Huang-Chih Chou distribution of women included in each of the three groups, with almost half of all women in the typical group (49.20%) aged between 40-69 years, versus 37.79% and 36.69% in the risperidone and other atypical groups. In Taiwan, BC incidence rates increase markedly after 49 years of age [3], and the disparity in age distribution between groups may have caused the difference in BC incidence rates in the crude analysis.…”

“…In Taiwan, BC is also one of the most common cancers and the fourth leading cause of cancer death in women [2]. Between 1997 and 2013, the incidence of BC in Taiwan increased from 52.3 to 93.0 per 100,000 person-years, and the median age at diagnosis was 52.6 years [3].…”

Tamoxifen use correlates with increased risk of hip fractures in older women with breast cancer: A case–control study in Taiwan

“…After analyzing nationwide health insurance claims data, Liu et al reported that the incidence of breast cancer almost doubled from 52.34 per 100 000 person‐years in 1997 to 93.00 per 100 000 person‐years in 2013. Even though the overall 5‐year mortality rate was similar between 1997 and 2008 (4.5% vs 4.5%), the mortality rate of patients with breast cancer and comorbidities in Taiwan improved (39.1% vs 21.1%) . Long‐term quality of life is, therefore, an important issue in patients with breast cancer, particularly older patients or those with comorbidities.…”

“…Even though the overall 5-year mortality rate was similar between 1997 and 2008 (4.5% vs 4.5%), the mortality rate of patients with breast cancer and comorbidities in Taiwan improved (39.1% vs 21.1%). 2 Long-term quality of life is, therefore, an important issue in patients with breast cancer, particularly older patients or those with comorbidities.…”