Global burden and trends in premenopausal and postmenopausal breast cancer: a population-based study
Global burden and trends in premenopausal and postmenopausal breast cancer: a population-based study
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DOI：
10.1016/s2214-109x(20)30215-1
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发表时间：
2020-08-01
影响因子：
34.3
通讯作者：
Fidler-Benaoudia, Miranda M.
中科院分区：
文献类型：
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作者：
Heer, Emily;Harper, Andrew;Fidler-Benaoudia, Miranda M.
背景乳腺癌在绝经前和绝经后年龄的患者中有不同的病因、病程、结局和影响。我们试图评估全球的负担和趋势，乳腺癌的绝经status.Methods我们做了一个基于人口的分析全球乳腺癌的发病率和死亡率之间的绝经前和绝经后妇女。月经状态是以年龄为代表来定义的，其中50岁或50岁以上的乳腺癌病例或死亡被视为绝经后。使用GLOBOCAN数据计算了2018年的标准化乳腺癌发病率和死亡率。使用五大洲癌症数据库，通过计算年平均百分比变化，对来自41个国家的44个人群的1998-2012年发病率趋势进行了评估。结果2018年，全球诊断出约64.5万例绝经前乳腺癌病例和1个中心点400万例绝经后乳腺癌病例，在每个绝经组中分别有超过130000和490000人死亡。与高收入国家相比，开发计划署人类发展指数低的国家在绝经前乳腺癌的新病例和死亡方面面临更大的负担。HDI非常高的国家绝经前和绝经后乳腺癌发病率最高（分别为每10万人中有30例中心点6和253例中心点6病例），而HDI低和中等的国家绝经前和绝经后死亡率最高（分别为每10万人中有8例中心点5和53例中心点3死亡）。在检查乳腺癌趋势时，我们注意到44个人群中有20个人群的绝经前乳腺癌年龄标准化发病率（ASIR）显著增加，44个人群中有24个人群的绝经后乳腺癌ASIR显著增加。仅在绝经前年龄的增长主要发生在高收入国家，而绝经后乳腺癌负担的增加是最显着的转型期countries under transitions.Interpretation我们提供的证据表明，全球范围内绝经前和绝经后乳腺癌的负担不断上升。虽然早期诊断和获得治疗在低收入和中等收入国家仍然至关重要，但世界所有区域都有必要开展初级预防工作，设法减少已知乳腺癌风险因素的影响，以遏制未来的乳腺癌负担。版权所有（c）2020世界卫生组织。这是一篇在CC BY-NC-ND 3.0 IGO许可下发布的开放获取文章，允许用户下载和分享文章用于非商业目的，只要文章全文复制而不作更改，并提供正确引用的原始来源。本条款不得用于商业产品、服务或任何实体的推广。不应暗示世卫组织认可任何特定组织、产品或服务。不允许使用世卫组织徽标。此通知应与文章的原始URL一起保存沿着。
Background Breast cancer has distinct causes, prognoses, and outcomes and effects in patients at premenopausal and postmenopausal ages. We sought to assess the global burden and trends in breast cancer by menopausal status.Methods We did a population-based analysis of global breast cancer incidence and mortality among premenopausal and postmenopausal women. Menopausal status was defined using age as a proxy, whereby breast cancer cases or deaths at age 50 years or older were regarded as postmenopausal. Age-standardised breast cancer incidence and mortality in 2018 were calculated using GLOBOCAN data. Incidence trends for 1998-2012 were assessed in 44 populations from 41 countries using the Cancer in Five Continents plus database, by calculating the annual average percent change.Findings Approximately 645 000 premenopausal and 1 center dot 4 million postmenopausal breast cancer cases were diagnosed worldwide in 2018, with more than 130 000 and 490 000 deaths occurring in each menopausal group, respectively. Proportionally, countries with a low UNDP human development index (HDI) faced a greater burden of premenopausal breast cancer for both new cases and deaths compared with higher income countries. Countries with a very high HDI had the highest premenopausal and postmenopausal breast cancer incidence (30 center dot 6 and 253 center dot 6 cases per 100 000, respectively), whereas countries with low and medium HDI had the highest premenopausal and postmenopausal mortality, respectively (8 center dot 5 and 53 center dot 3 deaths per 100 000, respectively). When examining breast cancer trends, we noted significantly increasing age-standardised incidence rates (ASIRs) for premenopausal breast cancer in 20 of 44 populations and significantly increasing ASIRs for postmenopausal breast cancer in 24 of 44 populations. The growth exclusively at premenopausal ages largely occurred in high-income countries, whereas the increasing postmenopausal breast cancer burden was most notable in countries under transition.Interpretation We provide evidence of a rising burden of both premenopausal and postmenopausal breast cancer worldwide. Although early diagnosis and access to treatment remain crucial in low-income and middle-income countries, primary prevention efforts seeking to decrease exposure to known breast cancer risk factors are warranted in all world regions to curb the future breast cancer burden. Copyright (c) 2020 World Health Organization. Published by Elsevier Ltd. This is an Open Access article published under the CC BY-NC-ND 3.0 IGO license, which permits users to download and share the article for non-commercial purposes, so long as the article is reproduced in the whole without changes, and provided the original source is properly cited. This article shall not be used or reproduced in association with the promotion of commercial products, services or any entity. There should be no suggestion that WHO endorses any specific organisation, products or services. The use of the WHO logo is not permitted. This notice should be preserved along with the article's original URL.