What are the long-term US trends in the incidence of breast cancer?

Updated: Dec 26, 2019
  • Author: Graham A Colditz, MD, DrPH; Chief Editor: Chandandeep Nagi, MD  more...
  • Print
Answer

Answer

Incidence rates of breast cancer rose steadily until 2002, when a rapid drop in incidence was observed. [12] Data from the SEER program, which began in 1973, confirm the trends in incidence most clearly monitored in the longstanding Connecticut registry. Increases have occurred in all age groups since 1935, although the magnitude of increase has been greater in older women. In the past few decades, incidence rates have increased more sharply among younger black women than white women; according to SEER data, from 1975-2000, incidence rates among black women younger than 50 years increased by 22% compared with 10% among white women younger than 50 years. Among women aged 50 years and older, the increase over this interval was 40% for both black and white women.

Long-term trends in incidence rates of DCIS and invasive female breast cancer (1975-2016) showed a rise in DCIS incidence between 1983 to about 1999 and then a relatively steady rate between 2000 and 2011 before a decrease of about 2.1% per year around 2012-2016. [3] Women 50 years and older had the greatest DCIS incidence. For invasive breast cancer, the incidence was also greatest in women 50 years and older, with a rapid rise between 1987 to 2000 (attributed to increased mammography use) followed by a sharp drop between 1994 and 2004 (mostly attributed to reduction in use of menopausal hormones, but also in part to small declines in mammography screening after 2000; the drop was limited mainly to white women with estrogen-receptor positive disease). [3]

Several studies have examined whether the increase in breast cancer incidence in the United States has resulted from to the increasing use of screening mammography. Because screening causes an increase in incidence and a shift in stage at diagnosis to earlier or smaller lesions and because its use was limited before the 1980s, it can explain little of the long-term increase between the 1930s and 1980s. However, during the 1980s, the increased incidence was due almost entirely to an increase in localized disease and in tumors measuring less than 2 cm in diameter; the incidence of tumors 2 cm or larger remained stable. Hence, this increase was largely a function of screening detecting tumors early.


Did this answer your question?
Additional feedback? (Optional)
Thank you for your feedback!