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Breast and cervical cancer in 187 countries between 1980 and 2010: a systematic analysis



Breast and cervical cancer in 187 countries between 1980 and 2010: a systematic analysis

Mohammad H Forouzanfar MD, Kyle J Foreman MPH, Allyne M Delossantos BS, Prof Rafael Lozano MD, Prof Alan D Lopez PhD, Prof, Dr Christopher J L Murray MD, Mohsen Naghavi MD

The Lancet,
378:9801, September 15, 2011

Breast and cervical cancer in 187 countries between 1980 and 2010: a systematic analysis

Background
Breast and cervical cancer are important causes of mortality in women aged ≥15 years. We undertook annual age-specific assessments of breast and cervical cancer in 187 countries.


Methods
We systematically collected cancer registry data on mortality and incidence, vital registration, and verbal autopsy data for the period 1980—2010. We modelled the mortality-to-incidence (MI) ratio using a hierarchical model. Vital registration and verbal autopsy were supplemented with incidence multiplied by the MI ratio to yield a comprehensive database of mortality rates. We used Gaussian process regression to develop estimates of mortality with uncertainty by age, sex, country, and year. We used out-of-sample predictive validity to select the final model. Estimates of incidence with uncertainty were also generated with mortality and MI ratios.

 

Findings
Global breast cancer incidence increased from 641 000 (95% uncertainty intervals 610 000—750 000) cases in 1980 to 1 643 000 (1 421 000—1 782 000) cases in 2010, an annual rate of increase of 3·1%. Global cervical cancer incidence increased from 378 000 (256 000—489 000) cases per year in 1980 to 454 000 (318 000—620 000) cases per year in 2010—a 0·6% annual rate of increase. Breast cancer killed 425 000 (359 000—453 000) women in 2010, of whom 68 000 (62 000—74 000) were aged 15—49 years in developing countries. Cervical cancer death rates have been decreasing but the disease still killed 200 000 (139 000—276 000) women in 2010, of whom 46 000 (33 000—64 000) were aged 15—49 years in developing countries. We recorded pronounced variation in the trend in breast cancer mortality across regions and countries.

 

Interpretation
More policy attention is needed to strengthen established health-system responses to reduce breast and cervical cancer, especially in developing countries.







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Prepared by: Dr. Houssam Al-Nahhas






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