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Changing pattern of age-specific breast cancer incidence in the Swiss canton of Geneva

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Published in Breast Cancer Research and Treatment. 2010, vol. 120, no. 2, p. 519-23
Collection Open Access - Licence nationale Springer
Abstract Hormone replacement therapy (HRT) use declined sharply after mid-2002, when the Women's Health Initiative trial reported an association between breast cancer occurrence and HRT. Hypothesized mechanism behind this association is that HRT promotes growth of pre-existing small tumors, leading to earlier tumor detection. We evaluated the impact of the sudden decline in HRT use on age distribution of breast cancer in Geneva. We included all incident breast cancer cases recorded from 1975 to 2006 at the Geneva cancer registry. We calculated mean annual incidence rates per 100,000 for 2 year periods for three age groups and assessed temporal changes by joinpoint regression. We compared age-specific incidence curves for different periods, reflecting different prevalence rates of HRT use. After increasing constantly between 1986 and 2002 among women aged 50-69 years [annual percent change (APC): +4.4, P < 0.0001], rates declined sharply after 2003 (APC: -6.0; P = 0.0264). Age-specific breast cancer rates changed dramatically with changes in prevalence of HRT use. During low HRT prevalence, breast cancer incidence increased progressively with age, when HRT prevalence was reaching its maximum (1995-2002), higher rates were seen in 60- to 64-year-old women, with a concomitant decrease in risk among elderly. After the sudden decline in HRT use, the incidence peak diminished significantly and incidence increased again with age. Following the abrupt decline in HRT use in Geneva, breast cancer incidence rates among post-menopausal women decreased considerably with striking changes in age-specific incidence rates before, during and after the peak in HRT prevalence.
Keywords Age DistributionAgedBreast Neoplasms/epidemiologyEstrogen Replacement Therapy/utilizationFemaleHumansIncidenceMiddle AgedRegistriesSwitzerland/epidemiology
PMID: 19633953
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Article (Published version) (270 Kb) - public document Free access
Research groups Epidémiologie des tumeurs (1017)
Groupe Bouchardy Magnin Christine (Registre genevois des tumeurs) (532)
(ISO format)
BOUCHARDY MAGNIN, Christine et al. Changing pattern of age-specific breast cancer incidence in the Swiss canton of Geneva. In: Breast Cancer Research and Treatment, 2010, vol. 120, n° 2, p. 519-23. doi: 10.1007/s10549-009-0478-y https://archive-ouverte.unige.ch/unige:21426

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Deposited on : 2012-05-25

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