TAILIEUCHUNG - Breast cancer incidence and case fatality among 4.7 million women in relation to social and ethnic background: a population-based cohort study

At present, more than 200 population-based cancer registries exist in vari- ous parts of the world. They cover about 5% of the world’s population, but the proportion is much greater in developed countries than in developing ones. Moreover, in developing countries, registries are more likely to cover urban areas, where access to diagnostic and treatment services is better. Nationwide cancer registration operates in some countries such as England & Wales, Scotland, the Nordic countries, Canada, Australia, New Zealand, Israel, Cuba, Puerto Rico and The Gambia. The Danish Cancer Registry, found- ed in 1942, is the oldest functioning registry covering a national population. In most countries, however, population-based cancer registries. | Beiki et al. Breast Cancer Research 2012 14 R5 http content 14 1 R5 Breast Cancer RESEARCH RESEARCH ARTICLE Open Access Breast cancer incidence and case fatality among million women in relation to social and ethnic background a population-based cohort study Omid Beiki1 2 Per Hall3 Anders Ekbom4 and Tahereh Moradi 1 Abstract Introduction Incidence of breast cancer is increasing around the world and it is still the leading cause of cancer mortality in low- and middle-income countries. We utilized Swedish nationwide registers to study breast cancer incidence and case fatality to disentangle the effect of socioeconomic position SEP and immigration from the trends in native Swedes. Methods A nation-wide cohort of women in Sweden was followed between 1961 and 2007 and incidence rate ratio IRR and hazard ratio HR with 95 confidence intervals CIs were estimated using Poisson and Cox proportional regression models respectively. Results Incidence continued to increase however it remained lower among immigrants IRR 95 CI to but not among immigrants daughters IRR 95 CI to compared to native Swedes. Case fatality decreased over the last decades and was similar in native Swedes and immigrants. However case fatality was significantly 14 higher if cancer was diagnosed after age 50 and 20 higher if cancer was diagnosed in the most recent years among immigrants compared with native Swedes. Women with the highest SEP had significantly 20 to 30 higher incidence but had 30 to 40 lower case fatality compared with women with the lowest SEP irrespective of country of birth. Age at immigration and duration of residence significantly modified the incidence and case fatality. Conclusions Disparities found in case fatality among immigrants by age duration of residence age at immigration and country of birth emphasize the importance of targeting interventions on women that are not likely to attend screenings or are not likely to .

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