Incidence and Trends of Breast and Cervical Cancers: A Joinpoint Regression Analysis

Satyanarayana Labani; Smita Asthana; Abhinav Srivastava; Parul Vohra; Deepanshu Bhatia

doi:10.4103/ijmpo.ijmpo_83_20

Indian Journal of Medical and Paediatric Oncology, Inhaltsverzeichnis

CC BY-NC-ND 4.0 · Indian J Med Paediatr Oncol 2020; 41(05): 654-662
DOI: 10.4103/ijmpo.ijmpo_83_20

Original Article

Incidence and Trends of Breast and Cervical Cancers: A Joinpoint Regression Analysis

Satyanarayana Labani

Division of Epidemiology and Biostatistics, National Institute of Cancer Prevention and Research, Indian Council of Medical Research, Noida, Uttar Pradesh, India

,

Smita Asthana

Division of Epidemiology and Biostatistics, National Institute of Cancer Prevention and Research, Indian Council of Medical Research, Noida, Uttar Pradesh, India

,

Abhinav Srivastava

Division of Epidemiology and Biostatistics, National Institute of Cancer Prevention and Research, Indian Council of Medical Research, Noida, Uttar Pradesh, India

,

Parul Vohra

Division of Epidemiology and Biostatistics, National Institute of Cancer Prevention and Research, Indian Council of Medical Research, Noida, Uttar Pradesh, India

,

Deepanshu Bhatia

Division of Epidemiology and Biostatistics, National Institute of Cancer Prevention and Research, Indian Council of Medical Research, Noida, Uttar Pradesh, India

› Institutsangaben

Abstract

Background: Breast and cervical cancers are two major cancers affecting women's health. Breast cancer is the most invasive cancer, and cervical cancer is the fourth most leading cause of death among women. Analysis of updated incidence data and their trends would help policymakers in planning and organizing programs to reduce the burden. This study aims to present regional variations in recent years and study trends of both the cancers in India. Materials and Methods: For recent incidence rates of cervical and breast cancers, data were obtained from the National Cancer Registry Programme (NCRP) reports (2009–2011) for 25 registries and of 2012–2014 for 27 registries. Trends were studied for data obtained from different NCRP reports for the years 1982–2014 in six major registries. One in number of person who developed cancer and the annual Percentage change in incidence were calculated along with the trend analysis for both the cancers. The Joinpoint Regression Model was used for trend analysis. Results: The age-adjusted rate (AAR) of incidence of breast cancer in the South region was 36.78 in 2009–2011 as against the North region with 41 in 2012–2014. One in number who develop breast cancer remains highest in the North-East region but changed from 167 in 2009 to 200 in 2012. Cervical cancer was also the highest in the North-East region during 2009 and 2012. There is an increase in the overall cervical cancer incidence with 24.3 AAR in 2009 to 28.0 in 2012 and one in 200 who develop cervical cancer in 2009 to 250 in 2012. The trend analysis for six major registries showed an increase in the incidence of breast cancer, with the highest increase in New Delhi (3.22), and decrease in the incidence of cervical cancer, with the highest decrease in Mumbai (−1.21). Conclusion: There has been an exponential increasing trend in breast cancer and a steep declining linear trend in cervical cancer, conferring an inverse relationship between the two cancers. This trend is present in all the major cancer registries.

Keywords

Breast and cervical cancers - Joinpoint regression analysis - population-based cancer registry - trends

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References
1 World Cancer Report 2014. Ch. 5.12. World Health Organization; 2014. http://publications.iarc.fr/Non-Series-Publications/World-Cancer-Reports/World-Cancer-Report-2014. Available from: [Last accessed on 2019 Feb 25]
2 McGuire A, Brown JA, Malone C, McLaughlin R, Kerin MJ. Effects of age on the detection and management of breast cancer. Cancers (Basel) 2015; 7: 908-29
3 National Centre for Disease Informatics and Research. Three-year Report of Population Based Cancer Registries: 2009-2011: Report of 25 PBCRs in India. National Cancer Registry Programme and Indian Council Medical Research. http://www.ncdirindia.org/NCRP/ALL_NCRP_REPORTS/PBCR_REPORT_2009_2011/ALL_CONTENT/Main.htm. Available from: [Last accessed on 2019 Feb 25]
4 WHO. International Agency for Research on Cancer. https://gco.iarc.fr/today/data/factsheets/cancers/20-Breast-fact-sheet.pdf. Available from: [Last accessed on 2019 Feb 25]
5 Khokhar A. Breast cancer in India: Where do we stand and where do we go?. Asian Pac J Cancer Prev 2012; 13: 4861-6
6 Anuar NS, Zahari SS, Taib IA, Rahman MT. Effect of green and ripe Carica papaya epicarp extracts on wound healing and during pregnancy. Food Chem Toxicol 2008; 46: 2384-9
7 Laurance J. Breast Cancer Cases Rise 80% Since 1970s. Women Engage for a Common Future. https://www.wecf.eu/english/articles/2006/10/risks_breastcancer.php. Available from: [Last accessed on 2019 Feb 25]
8 Imaginis Corporation. Breast Cancer: Statistics on Incidence, Survival, and Screening. https://www.imaginis.com/general-information-on-breast-cancer/breast-cancer-statistics-on-incidence-survival-and-screening-2. Available from: [Last accessed on 2019 Feb 25]
9 Agarwal G, Pradeep PV, Aggarwal V, Yip CH, Cheung PS. Spectrum of breast cancer in Asian women. World J Surg 2007; 31: 1031-40
10 National Centre for Disease Informatics and Research. Three-year report of population based cancer registries 2006-2008: Report of 20 PBCRs. National Cancer Registry Programme and Indian Council Medical Research. http://www.ncdirindia.org/All_. Available from: Reports/PBCR_2006_08/PBCR_2006_2008.pdf. [Last accessed on 2019 Feb 25]
11 WHO. International Agency for Research on Cancer. https://gco.iarc.fr/today/data/factsheets/cancers/23-Cervix-uteri-fact-sheet.pdf. Available from: [Last accessed on 2019 Feb 25]
12 World Health Organization. Cervical Cancer Prevention and Control Saves Lives in the Republic of Korea. http://www9.who.int/features/2018/cervical-cancer-republic-of-korea/en/. Available from: [Last accessed on 2019 Feb 25]
13 World Health Organization. Fact Sheet No. 297: Cancer. https://www.scirp.org/((czeh2tfqyw2orz553k1w0r45))/reference/ReferencesPapers.aspx?ReferenceID=746327. Available from: [Last accessed on 2019 Feb 25].
14 Canavan TP, Doshi NR. Cervical cancer. Am Fam Physician 2000; 61: 1369-76
15 Asthana S, Chauhan S, Labani S. Breast and cervical cancer risk in India: An update. Indian J Public Health 2014; 58: 5-10
16 Murthy NS, Agarwal UK, Chaudhry K, Saxena S. A study on time trends in incidence of breast cancer – Indian scenario. Eur J Cancer Care (Engl) 2007; 16: 185-6
17 Murthy NS, Chaudhry K, Saxena S. Trends in cervical cancer incidence–Indian scenario. Eur J Cancer Prev 2005; 14: 513-8
18 Dhillon PK, Yeole BB, Dikshit R, Kurkure AP, Bray F. Trends in breast, ovarian and cervical cancer incidence in Mumbai, India over a 30-year period, 1976-2005: An age-period-cohort analysis. Br J Cancer 2011; 105: 723-30
19 Takiar R, Srivastav A. Time trend in breast and cervix cancer of women in India-(1990-2003). Asian Pac J Cancer Prev 2008; 9: 777-80
20 WHO. International Statistical Classification of Diseases and Related Health Problems (ICD 10). https://icd.who.int/browse10/2016/en#/II. Available from: [Last accessed on 2019 Feb 25]
21 National Centre for Disease Informatics and Research. Three-Year Report of Population Based Cancer Registries 2012-2014: Report of 27 PBCRs. National Cancer Registry Programme and Indian Council Medical Research. http://ncdirindia.org/All_Reports/PBCR_REPORT_2012_2014/ALL_CONTENT/Main.htm. Available from: [Last accessed on 2019 Feb 25]
22 National Cancer Registry Programme. Bangalore: Indian Council of Medical Research. Consolidated Report of the Population Based Cancer Registries 2001-2004. http://ncdirindia.org/NCRP/Rep1/PBCR_2001_2004.aspx. Available from: [Last accessed on 2019 Feb 25]
23 National Cancer Institute. Joinpoint Trend Analysis Software. Surveillance Research Program, Division of Cancer Control and Population Sciences. https://surveillance.cancer.gov/joinpoint/. Available from: [Last accessed on 2019 Feb 25]
24 Kim HJ, Fay MP, Feuer EJ, Midthune DN. Permutation tests for joinpoint regression with applications to cancer rates. Stat Med 2000; 19: 335-51
25 National Cancer Institute. Download Joinpoint Desktop Software. Surveillance Research Program, Division of Cancer Control and population sciences. https://surveillance.cancer.gov/joinpoint/download. Available from: [Last acessed on 2019 Feb 25]
26 U.S. Cancer Statistics Working Group. United States Cancer Statistics: 1999–2009 Incidence and Mortality Web-based Report. Department of Health and Human Services, Atlanta (GA): Centers for Disease Control and Prevention, and National Cancer Institute; 2013. http://www.cdc.gov/uscs. Available from: [Last accessed on 2019 Feb 25]
27 Torre LA, Bray F, Siegel RL, Ferlay J, Lortet-Tieulent J, Jemal A. Global cancer statistics, 2012. CA Cancer J Clin 2015; 65: 87-108
28 Bray F. Transitions in human development and the global Cancer burden. In: Wild CP. editor World Cancer Report 2014. Lyon: International Agency for Research on Cancer; https://www.drugsandalcohol.ie/28525/1/World%20Cancer%20Report.pdf. Available from: [Last accessed on 2019 Feb 25]
29 Bray F, Jacques F. Age standardization. In: Forman D, Bray F, Brewster DH, Mbalawa CG, Kohler B, Piñeros M. et al., editors Cancer Incidence in Five Continents. IARC Scientific Publication No. 164. Vol. 10. Ch. 7. Lyon: International Agency for Research on Cancer; https://ci5.iarc.fr/CI5I-X/old/vol10/CI5vol10.pdf. Available from: [Last accessed on 2019 Feb 25]
30 Forman D, Bray F, Brewster D, Mbalawa GC, Kohler B, Piñeros M. Cancer Incidence in Five Continents. 10. Lyon: International Agency for Research on Cancer; https://ci5.iarc.fr/CI5I-X/old/vol10/CI5vol10.pdf. et al. Available from: [Last accessed on 2019 Feb 25]
31 World Bank. Invest in Health. World Development Report 1993. Oxford: Oxford University Press; 1993: 195-324 https://www.nap.edu/read/5513/chapter/4#15. Available from: [Last acessed on 2019 Feb 25]
32 Porter P. “Westernizing” women's risks? Breast cancer in lower-income countries. N Engl J Med 2008; 358: 213-6
33 Sylla BS, Wild CP. A million Africans a year dying from cancer by 2030: What can cancer research and control offer to the continent?. Int J Cancer 2012; 130: 245-50
34 Parkin DM, Bray FI, Devesa SS. Cancer burden in the year 2000. The global picture. Eur J Cancer 2001; 37 Suppl 8: S4-66
35 Bigby J, Holmes MD. Disparities across the breast cancer continuum. Cancer Causes Control 2005; 16: 35-44
36 Kurkure AP, Yeole BB. Social inequalities in cancer with special reference to South Asian countries. Asian Pac J Cancer Prev 2006; 7: 36-40
37 MacMahon B. Epidemiology and the causes of breast cancer. Int J Cancer 2006; 118: 2373-8
38 Bray F, McCarron P, Parkin DM. The changing global patterns of female breast cancer incidence and mortality. Breast Cancer Res 2004; 6: 229-39
39 Korenman SG. Oestrogen window hypothesis of the aetiology of breast cancer. Lancet 1980; 1: 700-1
40 Gao YT, Shu XO, Dai Q, Potter JD, Brinton LA, Wen W. et al. Association of menstrual and reproductive factors with breast cancer risk: Results from the Shanghai breast cancer study. Int J Cancer 2000; 87: 295-300
41 Liu YT, Gao CM, Ding JH, Li SP, Cao HX, Wu JZ. et al. Physiological, reproductive factors and breast cancer risk in Jiangsu province of China. Asian Pac J Cancer Prev 2011; 12: 787-90
42 Yanhua C, Geater A, You J, Li L, Shaoqiang Z, Chongsuvivatwong V. et al. Reproductive variables and risk of breast malignant and benign tumours in Yunnan province, China. Asian Pac J Cancer Prev 2012; 13: 2179-84
43 Bhadoria AS, Kapil U, Sareen N, Singh P. Reproductive factors and breast cancer: A case-control study in tertiary care hospital of North India. Indian J Cancer 2013; 50: 316-21
44 Ewertz M, Jensen OM. Trends in the incidence of cancer of the corpus uteri in Denmark, 1943-1980. Am J Epidemiol 1984; 119: 725-32
45 Parkin DM, Bray F, Ferlay J, Pisani P. Global cancer statistics, 2002. CA Cancer J Clin 2005; 55: 74-108
46 Key TJ, Allen NE, Spencer EA, Travis RC. The effect of diet on risk of cancer. Lancet 2002; 360: 861-8
47 Yeole BB. Trends in cancer incidence in female breast, cervix uteri, corpus uteri, and ovary in India. Asian Pac J Cancer Prev 2008; 9: 119-22
48 Malvia S, Bagadi SA, Dubey US, Saxena S. Epidemiology of breast cancer in Indian women. Asia Pac J Clin Oncol 2017; 13: 289-95
49 Chaturvedi M, Vaitheeswaran K, Satishkumar K, Das P, Stephen S, Nandakumar A. Time trends in breast cancer among Indian women population: An analysis of population based cancer registry data. Indian J Surg Oncol 2015; 6: 427-34
50 Badwe RA, Dikshit R, Laversanne M, Bray F. Cancer incidence trends in India. Jpn J Clin Oncol 2014; 44: 401-7
51 American Cancer Society. Key Statistics for Cervical Cancer. https://www.cancer.org/cancer/cervical-cancer/about/key-statistics.html. Available from: [Last accessed on 2019 Feb 25]
52 Ravdin PM, Cronin KA, Howlader N, Berg CD, Chlebowski RT, Feuer EJ. et al. The decrease in breast-cancer incidence in 2003 in the United States. N Engl J Med 2007; 356: 1670-4
53 Da Costa AM, Hashim D, Fregnani JH, Weiderpass E. Overall survival and time trends in breast and cervical cancer incidence and mortality in the Regional Health District (RHD) of Barretos, São Paulo, Brazil. BMC Cancer 2018; 18: 1079
54 Jedy-Agba E, Curado MP, Ogunbiyi O, Oga E, Fabowale T, Igbinoba F. et al. Cancer incidence in Nigeria: A report from population-based cancer registries. Cancer Epidemiol 2012; 36: e271-8
55 Forouzanfar MH, Foreman KJ, Delossantos AM, Lozano R, Lopez AD, Murray CJ. et al. Breast and cervical cancer in 187 countries between 1980 and 2010: A systematic analysis. Lancet 2011; 378: 1461-84
56 Amarante MK, de Sousa Pereira N, Vitiello GA, Watanabe MA. Involvement of a mouse mammary tumor virus (MMTV) homologue in human breast cancer: Evidence for, against and possible causes of controversies. Microb Pathog 2019; 130: 283-94
57 Li N, Bi X, Zhang Y, Zhao P, Zheng T, Dai M. Human papillomavirus infection and sporadic breast carcinoma risk: A meta-analysis. Breast Cancer Res Treat 2011; 126: 515-20
58 International Collaboration of Epidemiological Studies of Cervical Cancer. Appleby P, Beral V, Berrington de González A, Colin D, Franceschi S. et al. Cervical cancer and hormonal contraceptives: Collaborative reanalysis of individual data for 16,573 women with cervical cancer and 35,509 women without cervical cancer from 24 epidemiological studies. Lancet 2007; 370: 1609-21
59 Collaborative Group on Hormonal Factors in Breast Cancer. Breast cancer and hormonal contraceptives: Collaborative reanalysis of individual data on 53 297 women with breast cancer and 100 239 women without breast cancer from 54 epidemiological studies. Lancet 1996; 347: 1713-27
60 Bjørge T, Hennig EM, Skare GB, Søreide O, Thoresen SO. Second primary cancers in patients with carcinoma in situ of the uterine cervix. The Norwegian experience 1970-1992. Int J Cancer 1995; 62: 29-33
61 Levi F, Randimbison L, Vecchia CL, Franceschi S. Incidence of invasive cancers following carcinoma in situ of the cervix. Br J Cancer 1996; 74: 1321-3
62 Hemminki K, Dong C, Vaittinen P. Second primary cancer after in situ and invasive cervical cancer. Epidemiology 2000; 11: 457-61
63 Evans HS, Newnham A, Hodgson SV, Møller H. Second primary cancers after cervical intraepithelial neoplasia III and invasive cervical cancer in Southeast England. Gynecol Oncol 2003; 90: 131-6
64 Kalliala I, Anttila A, Pukkala E, Nieminen P. Risk of cervical and other cancers after treatment of cervical intraepithelial neoplasia: Retrospective cohort study. BMJ 2005; 331: 1183-5
65 Jakobsson M, Pukkala E, Paavonen J, Tapper AM, Gissler M. Cancer incidence among Finnish women with surgical treatment for cervical intraepithelial neoplasia, 1987-2006. Int J Cancer 2011; 128: 1187-91
66 Hansen BT, Nygård M, Falk RS, Hofvind S. Breast cancer and ductal carcinoma in situ among women with prior squamous or glandular precancer in the cervix: A register-based study. Br J Cancer 2012; 107: 1451-3