Changes in breast cancer incidence and mortality in middle-aged and elderly women in 28 countries with Caucasian majority populations

Background: Mammography screening and menopause hormone therapy is essentially offered to women 50-69 years old. Methods: In 28 European ancestry countries, we quantified changes in breast cancer incidence and mortality using a joinpoint regression analysis from 1960 until last year of available data. Results: Since 1960, increases in incidence often in the order of 2%-3% per year occurred in all countries, mainly in women 50-69 years old whose incidence in eight countries surpassed the incidence in women 70 years old and more. In 10 countries, a decrease in incidence in women >= 70 years was noticeable in the last years of observation, but the magnitude of this decrease was far from matching the magnitude of the increases observed in the 50-69 age-group. In the beginning of years 2000s, a persistent decrease in mortality of similar to 2% per year was observed in women 50-69 years old in most countries and parallel declines in mortality were observed in women 70 years or more. Conclusions: In years 2000s, in a number of countries, the incidence of breast cancer has become greater in middle-aged women than in older women. If trends remain unchanged, the same phenomenon is likely to happen in other countries.