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Competing risks to breast cancer mortality in Catalonia.

Vilaprinyo E, Gispert R, Martínez-Alonso M, Carles M, Pla R, Espinàs JA, Rué M - BMC Cancer (2008)

Bottom Line: The multi-decrement life table methodology was used.First, all-cause mortality probabilities were obtained by age and cohort.Our results are consistent with US findings.

View Article: PubMed Central - HTML - PubMed

Affiliation: Institut d'Investigació Biomèdica de Bellvitge, IDIBELL, Hospitalet de Llobregat Catalonia, Spain. evilaprinyo@cmb.udl.cat

ABSTRACT

Background: Breast cancer mortality has experienced important changes over the last century. Breast cancer occurs in the presence of other competing risks which can influence breast cancer incidence and mortality trends. The aim of the present work is: 1) to assess the impact of breast cancer deaths among mortality from all causes in Catalonia (Spain), by age and birth cohort and 2) to estimate the risk of death from other causes than breast cancer, one of the inputs needed to model breast cancer mortality reduction due to screening or therapeutic interventions.

Methods: The multi-decrement life table methodology was used. First, all-cause mortality probabilities were obtained by age and cohort. Then mortality probability for breast cancer was subtracted from the all-cause mortality probabilities to obtain cohort life tables for causes other than breast cancer. These life tables, on one hand, provide an estimate of the risk of dying from competing risks, and on the other hand, permit to assess the impact of breast cancer deaths on all-cause mortality using the ratio of the probability of death for causes other than breast cancer by the all-cause probability of death.

Results: There was an increasing impact of breast cancer on mortality in the first part of the 20th century, with a peak for cohorts born in 1945-54 in the 40-49 age groups (for which approximately 24% of mortality was due to breast cancer). Even though for cohorts born after 1955 there was only information for women under 50, it is also important to note that the impact of breast cancer on all-cause mortality decreased for those cohorts.

Conclusion: We have quantified the effect of removing breast cancer mortality in different age groups and birth cohorts. Our results are consistent with US findings. We also have obtained an estimate of the risk of dying from competing-causes mortality, which will be used in the assessment of the effect of mammography screening on breast cancer mortality in Catalonia.

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Probabilities of breast cancer death () for selected calendar years.
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Figure 3: Probabilities of breast cancer death () for selected calendar years.

Mentions: The impact of removing breast cancer as a cause of death is small under age 30 and over age 70. Below age 30 the number of breast cancer cases is small and above age 70 mortality from other causes, such as cardiovascular diseases, increases. The largest impact of removing breast cancer as a cause of death in overall mortality is observed at ages 40–54. For specific birth cohorts, the largest observed impact was in the 40–44 age group for cohorts born in 1945–49 and the 45–49 age group for cohorts born in 1950–54 (24% of all-cause mortality for both cohorts). Impacts assessed using observed data for cohorts born after 1955 tended to decrease. This finding is further supported by Figure 3, which shows the trend of breast cancer mortality by age for five year periods from 1975–79 to 2000–04. Breast cancer probability of death increased in all age groups from 1975–79 to 1990–94. In contrast, the last two studied periods, 1995–99 and 2000–04, show a reduction in breast cancer risk of death. Furthermore, Figure 4 shows how breast cancer mortality probabilities increased until the early 1990s, and then began to decrease, in all age groups.


Competing risks to breast cancer mortality in Catalonia.

Vilaprinyo E, Gispert R, Martínez-Alonso M, Carles M, Pla R, Espinàs JA, Rué M - BMC Cancer (2008)

Probabilities of breast cancer death () for selected calendar years.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2636833&req=5

Figure 3: Probabilities of breast cancer death () for selected calendar years.
Mentions: The impact of removing breast cancer as a cause of death is small under age 30 and over age 70. Below age 30 the number of breast cancer cases is small and above age 70 mortality from other causes, such as cardiovascular diseases, increases. The largest impact of removing breast cancer as a cause of death in overall mortality is observed at ages 40–54. For specific birth cohorts, the largest observed impact was in the 40–44 age group for cohorts born in 1945–49 and the 45–49 age group for cohorts born in 1950–54 (24% of all-cause mortality for both cohorts). Impacts assessed using observed data for cohorts born after 1955 tended to decrease. This finding is further supported by Figure 3, which shows the trend of breast cancer mortality by age for five year periods from 1975–79 to 2000–04. Breast cancer probability of death increased in all age groups from 1975–79 to 1990–94. In contrast, the last two studied periods, 1995–99 and 2000–04, show a reduction in breast cancer risk of death. Furthermore, Figure 4 shows how breast cancer mortality probabilities increased until the early 1990s, and then began to decrease, in all age groups.

Bottom Line: The multi-decrement life table methodology was used.First, all-cause mortality probabilities were obtained by age and cohort.Our results are consistent with US findings.

View Article: PubMed Central - HTML - PubMed

Affiliation: Institut d'Investigació Biomèdica de Bellvitge, IDIBELL, Hospitalet de Llobregat Catalonia, Spain. evilaprinyo@cmb.udl.cat

ABSTRACT

Background: Breast cancer mortality has experienced important changes over the last century. Breast cancer occurs in the presence of other competing risks which can influence breast cancer incidence and mortality trends. The aim of the present work is: 1) to assess the impact of breast cancer deaths among mortality from all causes in Catalonia (Spain), by age and birth cohort and 2) to estimate the risk of death from other causes than breast cancer, one of the inputs needed to model breast cancer mortality reduction due to screening or therapeutic interventions.

Methods: The multi-decrement life table methodology was used. First, all-cause mortality probabilities were obtained by age and cohort. Then mortality probability for breast cancer was subtracted from the all-cause mortality probabilities to obtain cohort life tables for causes other than breast cancer. These life tables, on one hand, provide an estimate of the risk of dying from competing risks, and on the other hand, permit to assess the impact of breast cancer deaths on all-cause mortality using the ratio of the probability of death for causes other than breast cancer by the all-cause probability of death.

Results: There was an increasing impact of breast cancer on mortality in the first part of the 20th century, with a peak for cohorts born in 1945-54 in the 40-49 age groups (for which approximately 24% of mortality was due to breast cancer). Even though for cohorts born after 1955 there was only information for women under 50, it is also important to note that the impact of breast cancer on all-cause mortality decreased for those cohorts.

Conclusion: We have quantified the effect of removing breast cancer mortality in different age groups and birth cohorts. Our results are consistent with US findings. We also have obtained an estimate of the risk of dying from competing-causes mortality, which will be used in the assessment of the effect of mammography screening on breast cancer mortality in Catalonia.

Show MeSH
Related in: MedlinePlus