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. 1993 Dec;68(6):1247–1253. doi: 10.1038/bjc.1993.513

Trends in breast cancer incidence in Sweden 1958-1988 by time period and birth cohort.

I Persson 1, R Bergström 1, P Sparén 1, M Thörn 1, H O Adami 1
PMCID: PMC1968654  PMID: 8260381

Abstract

Statistics from the Swedish National Cancer Registry based on all 110,658 cases of invasive breast cancer during the 31-year period 1958-1988 were analysed. Age-specific incidence rates increased over successive calendar periods. The average annual increase in the age-standardised incidence rate was 1.3%, with the greatest percentage changes among the youngest age groups. During the latter half of the study period, the rates of increase tended to diminish in the youngest age groups and even reversed significantly among women from 75 years of age. In analyses using age-period-cohort models, the best fit of the cancer incidence data was found for the full model which simultaneously considered the effects of age, period and cohort. Cohort effects were found to be more important than period effects, in terms of model fit. These effects emerged as a seemingly consistent, and in a logarithmic scale, fairly linear increase in the relative risk of breast cancer incidence with a 3-fold elevation in women born in the 1950's relative to those born in the 1880's. It is concluded that the rising breast cancer incidence in Sweden is explained chiefly by birth cohort effects, which indicate persistent secular changes in largely unknown risk factors associated with life style. We could not in the present data see any clear evidence for an adverse effect of contraceptive or replacement sex steroids on breast cancer incidence.

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Selected References

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  1. Adami H. O., Bergström R., Lund E., Meirik O. Absence of association between reproductive variables and the risk of breast cancer in young women in Sweden and Norway. Br J Cancer. 1990 Jul;62(1):122–126. doi: 10.1038/bjc.1990.242. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Bengtsson C., Lindquist O., Redvall L. Menstrual status and menopausal age of middle-aged Swedish women. A population study of women in Göteborg 1968--69 and 1974--75. Acta Obstet Gynecol Scand. 1981;60(3):269–275. doi: 10.3109/00016348109158130. [DOI] [PubMed] [Google Scholar]
  3. Bergkvist L., Adami H. O., Persson I., Hoover R., Schairer C. The risk of breast cancer after estrogen and estrogen-progestin replacement. N Engl J Med. 1989 Aug 3;321(5):293–297. doi: 10.1056/NEJM198908033210505. [DOI] [PubMed] [Google Scholar]
  4. Caygill C. P., Hill M. J. Trends in European breast cancer incidence and possible etiology. Tumori. 1991 Apr 30;77(2):126–129. doi: 10.1177/030089169107700207. [DOI] [PubMed] [Google Scholar]
  5. Clayton D., Schifflers E. Models for temporal variation in cancer rates. I: Age-period and age-cohort models. Stat Med. 1987 Jun;6(4):449–467. doi: 10.1002/sim.4780060405. [DOI] [PubMed] [Google Scholar]
  6. Devesa S. S., Silverman D. T., Young J. L., Jr, Pollack E. S., Brown C. C., Horm J. W., Percy C. L., Myers M. H., McKay F. W., Fraumeni J. F., Jr Cancer incidence and mortality trends among whites in the United States, 1947-84. J Natl Cancer Inst. 1987 Oct;79(4):701–770. [PubMed] [Google Scholar]
  7. Ekbom A., Trichopoulos D., Adami H. O., Hsieh C. C., Lan S. J. Evidence of prenatal influences on breast cancer risk. Lancet. 1992 Oct 24;340(8826):1015–1018. doi: 10.1016/0140-6736(92)93019-j. [DOI] [PubMed] [Google Scholar]
  8. Ewertz M., Carstensen B. Trends in breast cancer incidence and mortality in Denmark, 1943-1982. Int J Cancer. 1988 Jan 15;41(1):46–51. doi: 10.1002/ijc.2910410110. [DOI] [PubMed] [Google Scholar]
  9. Ewertz M., Duffy S. W., Adami H. O., Kvåle G., Lund E., Meirik O., Mellemgaard A., Soini I., Tulinius H. Age at first birth, parity and risk of breast cancer: a meta-analysis of 8 studies from the Nordic countries. Int J Cancer. 1990 Oct 15;46(4):597–603. doi: 10.1002/ijc.2910460408. [DOI] [PubMed] [Google Scholar]
  10. Glass A. G., Hoover R. N. Rising incidence of breast cancer: relationship to stage and receptor status. J Natl Cancer Inst. 1990 Apr 18;82(8):693–696. doi: 10.1093/jnci/82.8.693. [DOI] [PubMed] [Google Scholar]
  11. Harris J. R., Lippman M. E., Veronesi U., Willett W. Breast cancer (1) N Engl J Med. 1992 Jul 30;327(5):319–328. doi: 10.1056/NEJM199207303270505. [DOI] [PubMed] [Google Scholar]
  12. Holford T. R., Roush G. C., McKay L. A. Trends in female breast cancer in Connecticut and the United States. J Clin Epidemiol. 1991;44(1):29–39. doi: 10.1016/0895-4356(91)90198-i. [DOI] [PubMed] [Google Scholar]
  13. Holford T. R. Understanding the effects of age, period, and cohort on incidence and mortality rates. Annu Rev Public Health. 1991;12:425–457. doi: 10.1146/annurev.pu.12.050191.002233. [DOI] [PubMed] [Google Scholar]
  14. Kelsey J. L. A review of the epidemiology of human breast cancer. Epidemiol Rev. 1979;1:74–109. doi: 10.1093/oxfordjournals.epirev.a036215. [DOI] [PubMed] [Google Scholar]
  15. Kohlmeier L., Rehm J., Hoffmeister H. Lifestyle and trends in worldwide breast cancer rates. Ann N Y Acad Sci. 1990;609:259–268. doi: 10.1111/j.1749-6632.1990.tb32073.x. [DOI] [PubMed] [Google Scholar]
  16. Lindgren R., Berg G., Hammar M., Zuccon E. Hormonal replacement therapy and sexuality in a population of Swedish postmenopausal women. Acta Obstet Gynecol Scand. 1993 May;72(4):292–297. doi: 10.3109/00016349309068040. [DOI] [PubMed] [Google Scholar]
  17. Ljung B. O., Bergsten-Brucefors A., Lindgren G. The secular trend in physical growth in Sweden. Ann Hum Biol. 1974 Jul;1(3):245–256. doi: 10.1080/03014467400000291. [DOI] [PubMed] [Google Scholar]
  18. Longnecker M. P., Berlin J. A., Orza M. J., Chalmers T. C. A meta-analysis of alcohol consumption in relation to risk of breast cancer. JAMA. 1988 Aug 5;260(5):652–656. [PubMed] [Google Scholar]
  19. Mattsson B., Wallgren A. Completeness of the Swedish Cancer Register. Non-notified cancer cases recorded on death certificates in 1978. Acta Radiol Oncol. 1984;23(5):305–313. doi: 10.3109/02841868409136026. [DOI] [PubMed] [Google Scholar]
  20. Meirik O., Lund E., Adami H. O., Bergström R., Christoffersen T., Bergsjö P. Oral contraceptive use and breast cancer in young women. A joint national case-control study in Sweden and Norway. Lancet. 1986 Sep 20;2(8508):650–654. doi: 10.1016/s0140-6736(86)90166-2. [DOI] [PubMed] [Google Scholar]
  21. Miller A. B., Bulbrook R. D. UICC Multidisciplinary Project on Breast Cancer: the epidemiology, aetiology and prevention of breast cancer. Int J Cancer. 1986 Feb 15;37(2):173–177. doi: 10.1002/ijc.2910370202. [DOI] [PubMed] [Google Scholar]
  22. Moore D. H., Moore D. H., 2nd, Moore C. T. Breast carcinoma etiological factors. Adv Cancer Res. 1983;40:189–253. doi: 10.1016/s0065-230x(08)60681-8. [DOI] [PubMed] [Google Scholar]
  23. Persson I., Adami H. O., Johansson E., Lindberg B., Manell P., Westerholm B. Cohort study of oestrogen treatment and the risk of endometrial cancer: evaluation of method and its applicability. Eur J Clin Pharmacol. 1983;25(5):625–632. doi: 10.1007/BF00542350. [DOI] [PubMed] [Google Scholar]
  24. Ranstam J., Janzon L., Olsson H. Rising incidence of breast cancer among young women in Sweden. Br J Cancer. 1990 Jan;61(1):120–122. doi: 10.1038/bjc.1990.24. [DOI] [PMC free article] [PubMed] [Google Scholar]
  25. Stanley K., Stjernswärd J., Koroltchouk V. Cancers of the stomach, lung and breast: mortality trends and control strategies. World Health Stat Q. 1988;41(3-4):107–114. [PubMed] [Google Scholar]
  26. Steinberg K. K., Thacker S. B., Smith S. J., Stroup D. F., Zack M. M., Flanders W. D., Berkelman R. L. A meta-analysis of the effect of estrogen replacement therapy on the risk of breast cancer. JAMA. 1991 Apr 17;265(15):1985–1990. [PubMed] [Google Scholar]
  27. Tabár L., Fagerberg C. J., Gad A., Baldetorp L., Holmberg L. H., Gröntoft O., Ljungquist U., Lundström B., Månson J. C., Eklund G. Reduction in mortality from breast cancer after mass screening with mammography. Randomised trial from the Breast Cancer Screening Working Group of the Swedish National Board of Health and Welfare. Lancet. 1985 Apr 13;1(8433):829–832. doi: 10.1016/s0140-6736(85)92204-4. [DOI] [PubMed] [Google Scholar]
  28. White E., Daling J. R., Norsted T. L., Chu J. Rising incidence of breast cancer among young women in Washington State. J Natl Cancer Inst. 1987 Aug;79(2):239–243. [PubMed] [Google Scholar]
  29. White E., Lee C. Y., Kristal A. R. Evaluation of the increase in breast cancer incidence in relation to mammography use. J Natl Cancer Inst. 1990 Oct 3;82(19):1546–1552. doi: 10.1093/jnci/82.19.1546. [DOI] [PubMed] [Google Scholar]
  30. de Waard F., Trichopoulos D. A unifying concept of the aetiology of breast cancer. Int J Cancer. 1988 May 15;41(5):666–669. doi: 10.1002/ijc.2910410505. [DOI] [PubMed] [Google Scholar]

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