Skip to main content

Advertisement

Log in

On the rising trends of incidence and prognosis for breast cancer patients diagnosed 1975–2004: a long-term population-based study in southeastern Netherlands

  • Original Paper
  • Published:
Cancer Causes & Control Aims and scope Submit manuscript

Abstract

Background

Much progress has been made in the early diagnosis and treatment of breast cancer. We have assessed the changing burden of this disease, by means of a comprehensive description of trends in incidence, survival, and mortality.

Methods

Data on breast cancer patients diagnosed between 1975 and 2004 (n = 26,464) registered in the population-based Eindhoven Cancer Registry were investigated.

Results

Incidence for patients aged below 40 and 40–49 has increased by 2.1% and 2.4% annually, since 1995 (p = 0.08 and p = 0.001, respectively). Mortality decreased in all age groups, but most markedly among women aged 50–69 (−1.5% yearly since 1985, p = 0.14). The proportion of stage I tumors increased from 25% to 39%, that of advanced stages (III & IV) decreased from 30% (1975–1984) to 13% in 1995–2004, and the proportion of in situ tumors increased from 1.5% to 10%. Adjuvant systemic treatment was administered to 15% of patients in 1975–1984 vs. 49% in 1995–2004. Relative 10-year survival rates for women aged 50–69 (period analysis) increased from 53% to 75% between 1975 and 2004. The best prognosis was observed for women aged 45–54. Women younger than 35 had a particularly poor prognosis.

Conclusion

The observed improvement in survival of breast cancer patients during the last three decades is impressive. The peak in breast cancer incidence is not yet in sight considering the recent trends in exposure to known risk factors and improved diagnosis. The combination of increasing incidence and improved survival rates implies that the number of prevalent cases will continue to increase considerably in the next 10 years.

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
Fig. 4
Fig. 5
Fig. 6
Fig. 7

Similar content being viewed by others

References

  1. Ferlay J, Bray F, Pisani P, Parkin DM (2002) GLOBOCAN 2002. Cancer incidence, mortality and prevalence worldwide, 5.2 edn. IARC Press, Lyon

    Google Scholar 

  2. Tyczynski JE, Plesko I, Aareleid T, Primic-Zakelj M, Dalmas M, Kurtinaitis J, Stengrevics A, Parkin DM (2004) Breast cancer mortality patterns and time trends in 10 new EU member states: mortality declining in young women, but still increasing in the elderly. Int J Cancer 112:1056–1064

    Article  PubMed  CAS  Google Scholar 

  3. Bray F, Sankila R, Ferlay J, Parkin DM (2002) Estimates of cancer incidence and mortality in Europe in 1995. Eur J Cancer 38:99–166

    Article  PubMed  CAS  Google Scholar 

  4. Ferlay J, Bray F, Sankila R, Parkin DM (1999) EUCAN: Cancer incidence, mortality and prevalence in the European Union 1998, 5.0 edn. IARC, Lyon

    Google Scholar 

  5. Netherlands Cancer Registry (2005) http://www.ikcnet.nl/page.php?id=1865&nav_id=41. Accessed 24 April 2007

  6. Bray F, McCarron P, Parkin DM (2004) The changing global patterns of female breast cancer incidence and mortality. Breast Cancer Res 6:229–239

    Article  PubMed  Google Scholar 

  7. Nab HW, Hop WC, Crommelin MA, Kluck HM, van der Heijden LH, Coebergh JW (1994) Changes in long term prognosis for breast cancer in a Dutch cancer registry. BMJ 309:83–86

    PubMed  CAS  Google Scholar 

  8. Nab HW, Hop WC, Crommelin MA, Kluck HM, Coebergh JW (1994) Improved prognosis of breast cancer since 1970 in south-eastern Netherlands. Br J Cancer 70:285–288

    PubMed  CAS  Google Scholar 

  9. Louwman WJ, van Diest PJ, van Beek MW, Schapers RF, Nolthenius-Puylaert TM, Baak JP, Coeberg JW (2002) Trends in breast cancer aggressiveness before the introduction of mass screening in southeastern Netherlands 1975–1989. Breast Cancer Res Treat 73:199–206

    Article  PubMed  CAS  Google Scholar 

  10. Janssen-Heijnen MLG, Louwman WJ, van de Poll-Franse LV, Coebergh JWW (2005) Results of 50 years cancer registry in the South of the Netherlands: 1955–2004 (in Dutch). Eindhoven Cancer Registry, Eindhoven

    Google Scholar 

  11. Botha JL, Bray F, Sankila R, Parkin DM (2003) Breast cancer incidence and mortality trends in 16 European countries. Eur J Cancer 39:1718–1729

    Article  PubMed  CAS  Google Scholar 

  12. Sant M, Francisci S, Capocaccia R, Verdecchia A, Allemani C, Berrino F (2006) Should we use incidence, survival or mortality to assess breast cancer trends in European women? Nat Clin Pract Oncol 3:228–229

    Article  PubMed  Google Scholar 

  13. Parkin DM, Whelan SL, Ferlay J, Teppo L, Thomas DB (2002) Cancer incidence in five continents, vol VIII. IARC Scientific Publications, Lyon

    Google Scholar 

  14. Harmer MH (1978) TNM classification of malignant tumors, 3rd edn. IUCC, Geneva

    Google Scholar 

  15. Hermanek P, Sobin L (1992) TNM classification of malignant tumors, 4th edn, 2nd rev. edn. Springer-Verlag, Berlin

  16. Sobin LH, Wittekind C (1997) UICC international union against cancer. TNM classification of malignant tumours, 5th edn. Wiley-Liss, Geneva, Switzerland, p 227

    Google Scholar 

  17. Sobin LH, Wittekind C (2002) UICC International Union against Cancer. TNM classification of malignant tumours, 6th edn. Wiley-Liss, Geneva, Switzerland, p 239

    Google Scholar 

  18. Voogd AC, van Beek MW, Crommelin MA, Kluck HM, Repelaer van Driel OJ, Coebergh JW (1994) Management of early breast cancer in southeast Netherlands since 1984. A population-based study. Regional Breast Cancer Study Group. Acta Oncol 33:753–757

    Article  PubMed  CAS  Google Scholar 

  19. Rutgers EJ, Nortier JW, Tuut MK, van Tienhoven G, Struikmans H, Bontenbal M, von Meyenfeldt MF, Vreugdenhil G, Benraadt T, Garssen B, Peterse JL (2002) Dutch institute for healthcare improvement guideline, “Treatment of breast cancer”. Ned Tijdschr Geneeskd 146:2144–2151

    PubMed  Google Scholar 

  20. Clayton D, Schifflers E (1987) Models for temporal variation in cancer rates. I: age-period and age-cohort models. Stat Med 6:449–467

    Article  PubMed  CAS  Google Scholar 

  21. Hakulinen T, Abeywickrama KH (1985) A computer program package for relative survival analysis. Comput Programs Biomed 19:197–207

    Article  PubMed  CAS  Google Scholar 

  22. Houterman S, Janssen-Heijnen ML, van de Poll-Franse LV, Brenner H, Coebergh JW (2006) Higher long-term cancer survival rates in southeastern Netherlands using up-to-date period analysis. Ann Oncol 17:709–712

    Article  PubMed  CAS  Google Scholar 

  23. Brenner H, Gefeller O (1996) An alternative approach to monitoring cancer patient survival. Cancer 78:2004–2010

    Article  PubMed  CAS  Google Scholar 

  24. van Dijck JA, Hendriks JH, Holland R, Schouten LJ, Verbeek AL (2000) Alterations of stage distribution for breast cancer since the implementation of national screening program in the Netherlands during 1989–1995. Ned Tijdschr Geneeskd 144:1119–1124

    PubMed  Google Scholar 

  25. Fracheboud J, Otto SJ, van Dijck JA, Broeders MJ, Verbeek AL, de Koning HJ (2004) Decreased rates of advanced breast cancer due to mammography screening in The Netherlands. Br J Cancer 91:861–867

    PubMed  CAS  Google Scholar 

  26. Hankinson SDH (2002) Breast cancer. In: Adami HO, Hunter DDT (eds) Textbook of cancer epidemiologyed. Oxford Univeristy Press, Oxford, pp 301–339

    Google Scholar 

  27. Macmahon B (2006) Epidemiology and the causes of breast cancer. Int J Cancer 118:2373–2378

    Article  PubMed  CAS  Google Scholar 

  28. SignaleringscommissieKanker, De rol van voeding bij het ontstaan van kanker. KWF Kankerbestrijding (2004)

  29. SignaleringscommissieKanker, De rol van lichaamsbeweging bij preventie van kanker. KWF Kankerbestrijding (2005)

  30. 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 

  31. Robbins AS, Clarke CA (2007) Regional changes in hormone therapy use and breast cancer incidence in California from 2001 to 2004. J Clin Oncol 25:3437–3439

    Article  PubMed  Google Scholar 

  32. Rossouw JE, Anderson GL, Prentice RL, LaCroix AZ, Kooperberg C, Stefanick ML, Jackson RD, Beresford SA, Howard BV, Johnson KC, Kotchen JM, Ockene J (2002) Risks and benefits of estrogen plus progestin in healthy postmenopausal women: principal results from the women’s health initiative randomized controlled trial. Jama 288:321–33

    Article  PubMed  CAS  Google Scholar 

  33. Soerjomataram I, Louwman MW, Visser O, Van Leeuwen FE, Coebergh JW (2007) Does the decrease in hormone-replacement therapy also affect breast cancer risk in the Netherlands? J Clin Oncol 25:5038–5039

    Article  PubMed  Google Scholar 

  34. Lundberg V, Tolonen H, Stegmayr B, Kuulasmaa K, Asplund K (2004) Use of oral contraceptives and hormone replacement therapy in the WHO MONICA project. Maturitas 48:39–49

    Article  PubMed  CAS  Google Scholar 

  35. van Duijnhoven FJ, van Gils CH, Bezemer ID, Peeters PH, van der Schouw YT, Grobbee DE (2006) Use of hormones in the menopausal transition period in the Netherlands between 1993 and 1997. Maturitas 53:462–475

    Article  PubMed  CAS  Google Scholar 

  36. Levi F, Lucchini F, Negri E, Boyle P, La Vecchia C (2004) Cancer mortality in Europe, 1995–1999, and an overview of trends since 1960. Int J Cancer 110:155–169

    Article  PubMed  CAS  Google Scholar 

  37. Levi F, Lucchini F, Negri E, La Vecchia C (2004) Trends in mortality from major cancers in the European Union, including acceding countries, in 2004. Cancer 101:2843–2850

    Article  PubMed  Google Scholar 

  38. Otto SJ, Fracheboud J, Looman CW, Broeders MJ, Boer R, Hendriks JH, Verbeek AL, de Koning HJ (2003) Initiation of population-based mammography screening in Dutch municipalities and effect on breast-cancer mortality: a systematic review. Lancet 361:1411–1417

    Article  PubMed  Google Scholar 

  39. Jatoi I, Miller AB (2003) Why is breast-cancer mortality declining? Lancet Oncol 4:251–254

    Article  PubMed  Google Scholar 

  40. Welch HG, Schwartz LM, Woloshin S (2000) Are increasing 5-year survival rates evidence of success against cancer? Jama 283:2975–2978

    Article  PubMed  CAS  Google Scholar 

  41. Vervoort MM, Draisma G, Fracheboud J, van de Poll-Franse LV, de Koning HJ (2004) Trends in the usage of adjuvant systemic therapy for breast cancer in the Netherlands and its effect on mortality. Br J Cancer 91:242–247

    PubMed  CAS  Google Scholar 

  42. Berry DA, Cronin KA, Plevritis SK, Fryback DG, Clarke L, Zelen M, Mandelblatt JS, Yakovlev AY, Habbema JD, Feuer EJ (2005) Effect of screening and adjuvant therapy on mortality from breast cancer. N Engl J Med 353:1784–1792

    Article  PubMed  CAS  Google Scholar 

  43. Thomson CS, Brewster DH, Dewar JA, Twelves CJ (2004) Improvements in survival for women with breast cancer in Scotland between 1987 and 1993: impact of earlier diagnosis and changes in treatment. Eur J Cancer 40:743–753

    Article  PubMed  CAS  Google Scholar 

  44. Early Breast Cancer Trialists’ Collaborative Group (EBCTCG) (2005) Effects of chemotherapy, hormonal therapy for early breast cancer on recurrence and 15-year survival: an overview of the randomised trials. Lancet 365:1687–1717

    Google Scholar 

  45. Goldhirsch A, Glick JH, Gelber RD, Coates AS, Thurlimann B, Senn HJ (2005) Meeting highlights: international expert consensus on the primary therapy of early breast cancer 2005. Ann Oncol 16:1569–1583

    Article  PubMed  CAS  Google Scholar 

  46. Goldhirsch A, Wood WC, Gelber RD, Coates AS, Thurlimann B, Senn HJ (2003) Meeting highlights: updated international expert consensus on the primary therapy of early breast cancer. J Clin Oncol 21:3357–3365

    Article  PubMed  Google Scholar 

  47. Siesling S, van de Poll-Franse LV, Jobsen JJ, Repelaer van Driel OJ, Voogd AC (2005) Trends and variation in breast conserving surgery in the southeast and east of the Netherlands over the period 1990–2002. Ned Tijdschr Geneeskd 149:1941–1946

    PubMed  CAS  Google Scholar 

  48. Visser O, van Leeuwen FE (2005) Stage-specific survival of epithelial cancers in North-Holland/Flevoland, The Netherlands. Eur J Cancer 41:2321–2330

    Article  PubMed  CAS  Google Scholar 

  49. Feinstein AR, Sosin DM, Wells CK (1985) The Will Rogers phenomenon. Stage migration and new diagnostic techniques as a source of misleading statistics for survival in cancer. N Engl J Med 312:1604–1608

    Article  PubMed  CAS  Google Scholar 

  50. Adami HO, Malker B, Holmberg L, Persson I, Stone B (1986) The relation between survival and age at diagnosis in breast cancer. N Engl J Med 315:559–563

    Article  PubMed  CAS  Google Scholar 

  51. Sant M, Capocaccia R, Verdecchia A, Esteve J, Gatta G, Micheli A, Coleman MP, Berrino F (1998) Survival of women with breast cancer in Europe: variation with age, year of diagnosis and country. The EUROCARE Working Group. Int J Cancer 77:679–683

    Article  PubMed  CAS  Google Scholar 

  52. Mohle-Boetani J, Grosser S, Malec M, Whittemore AS (1986) Survival advantage among patients with breast cancer diagnosed at 45 to 49 years of age. N Engl J Med 315:587

    PubMed  CAS  Google Scholar 

  53. Holli K, Isola J (1997) Effect of age on the survival of breast cancer patients. Eur J Cancer 33:425–428

    Article  PubMed  CAS  Google Scholar 

  54. Kroman N, Jensen MB, Wohlfahrt J, Mouridsen HT, Andersen PK, Melbye M (2000) Factors influencing the effect of age on prognosis in breast cancer: population based study. BMJ 320:474–478

    Article  PubMed  CAS  Google Scholar 

  55. SignaleringscommissieKanker, Kanker in Nederland. Trends, prognoses en implicaties voor zorgvraag. KWF Kankerbestrijding (2004)

Download references

Acknowledgment

This study was partly supported by a grant from the Dutch Cancer Society (IKZ95-1012).

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to W. J. Louwman.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Louwman, W.J., Voogd, A.C., van Dijck, J.A.A.M. et al. 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 (2008). https://doi.org/10.1007/s10552-007-9075-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10552-007-9075-8

Keywords

Navigation