Predicted Burden of Breast Cancer in the United States
In a study reported in Journal of the National Cancer Institute, Rosenberg et al predicted that the number of new invasive plus in situ breast cancers will increase from approximately 283,000 in 2011 to 441,000 in 2030. Modeling suggests that the proportion of estrogen receptor–negative cases will decrease by approximately half over this time.
The study involved construction of forecasts for women aged 30 to 84 years in 2011 through 2030 using Surveillance, Epidemiology, and End Results (SEER) cancer incidence data, novel age–period cohort forecasting models, and population projections from the U.S. Census Bureau.
Expected Burden and Trends
The total number of new invasive plus in situ tumors was predicted to increase from 283,000 in 2011 to 441,000 in 2030 (plausible range = 353,500–466,700 cases). The proportion of all new cases in patients aged 70 to 84 years was predicted to increase from 24.3% to 34.8%, whereas the proportion of cases in patients aged 50 to 69 years was predicted to decrease from 54.7% to 43.6%.
The proportion of estrogen receptor–positive invasive cancers was predicted to remain approximately constant at 62.6%, with an increase in the proportion of estrogen receptor–positive in situ cancers from 19.1% to 28.9%. The incidence of invasive estrogen receptor–negative tumors decreased between 1992 and 2010 in all age groups; the current forecast indicates a reduction in the proportion of invasive and in situ estrogen receptor–negative cancers from 16.8% to 8.6%.
The investigators concluded: “Breast cancer overall will rise in the United States through 2030, especially for estrogen receptor–positive in situ tumors among women age 70 to 84 years. In contrast, estrogen receptor–negative invasive and in situ tumors will fall, for reasons that are not fully understood. These results highlight a need to optimize case management among older women, characterize the natural history of in situ cancers, and identify those factors responsible for declining estrogen receptor–negative incidence.”
The study was supported by the National Cancer Institute.
Philip S. Rosenberg, PhD, of the National Cancer Institute, is the corresponding author of the Journal of the National Cancer Institute article.
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