2017年10月4日，欧洲乳腺癌专科学会《乳腺》在线发表意大利米兰大学、西班牙纳瓦拉自治区医院的研究报告，分析了1970～2014年36个欧洲国家和欧盟的乳腺癌相关死亡趋势，并预测了2020年的死亡数和死亡率。
该研究从世界卫生组织和欧盟统计局数据库获得乳腺癌相关死亡证明数据和人口数字，并使用联结点回归模型获得2020年估算值。
结果发现，总体而言，欧盟乳腺癌相关死亡率（使用世界标准人口年龄标准化死亡率）自2002年17.9/10万降至2012年15.2/10万，降低幅度达15%；预测2020年为13.4/10万，降低幅度约12%。
年轻女性的乳腺癌相关死亡率降低最大（20～49岁，2002年与2012年相差-22%）。
在欧盟内部，英国与其他北欧和西欧国家的乳腺癌相关死亡率降低幅度大于中欧和东欧大部分地区。1970年，英国的乳腺癌相关死亡率最高，至2020年，英国的预测乳腺癌相关死亡率将仅高于西班牙。波兰的预测乳腺癌相关死亡率将上升，预计2020年将达15.3/10万。
2020年与1989年峰值相比，估计欧盟将可减少约3.25万例乳腺癌相关死亡，而1990～2020年期间共有47.5万例乳腺癌相关死亡。
因此，乳腺癌相关死亡总体趋势主要由于乳腺癌的管理和治疗持续改善，早期诊断和筛查也发挥了重要作用。改善中欧和东欧的乳腺癌管理为当务之急。
Breast. 2017 Oct 4. [Epub ahead of print]
Trends and predictions to 2020 in breast cancer mortality in Europe.
Greta Carioli, Matteo Malvezzi, Teresa Rodriguez, Paola Bertuccio, Eva Negri, Carlo La Vecchia.
Università degli Studi di Milano, Milan, Italy; Navarra Health Service, Pamplona, Spain.
HIGHLIGHTS
EU breast cancer mortality rates declined by 15% between 2002 and 2012.
We predict a further 10% decline in breast cancer mortality to 2020.
The falls were largest in the young.
Trends were less favourable in central and eastern than in western Europe.
The key determinant of the falls is management; early diagnosis contributed, too.
OBJECTIVES: We analyzed trends in mortality from breast cancer in women in 36 European countries and the European Union (EU) over the period 1970-2014, and predicted numbers of deaths and rates to 2020.
MATERIALS AND METHODS: We derived breast cancer death certification data and population figures from the World Health Organization and Eurostat databases. We obtained 2020 estimates using a joinpoint regression model.
RESULTS: Overall, EU breast cancer mortality rates (world standard) declined from 17.9/100,000 in 2002 to 15.2 in 2012. The predicted 2020 rate is 13.4/100,000. The falls were largest in young women (20-49 years, -22% between 2002 and 2012). Within the EU, declines were larger in the United Kingdom (UK) and other northern and western European countries than in most central and eastern Europe. The UK has the second lowest predicted breast cancer mortality rate in 2020 (after Spain), starting from the highest one in 1970. Breast cancer mortality is predicted to rise in Poland, where the predicted 2020 rate is 15.3/100,000. We estimated that about 32,500 breast cancer deaths will be avoided in 2020 in the EU as compared to the peak rate of 1989, and a total of 475,000 breast cancer deaths over the period 1990-2020.
CONCLUSION: The overall favourable breast cancer mortality trends are mainly due to a succession of improvements in the management and treatment of breast cancer, though early diagnosis and screening played a role, too. Improving breast cancer management in central and eastern Europe is a priority.
KEYWORDS: Breast; Cancer; Mortality; Trends; Projections; Europe
DOI: 10.1016/j.breast.2017.06.003
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