Epidemiology and survival outcome of breast cancer in a nationwide study
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Fu-Chao Liu1,2,*, Huan-Tang Lin1,2,*, Chang-Fu Kuo3,4, Lai-Chu See5,6, Meng-Jiun Chiou7, Huang-Ping Yu1,2
1Department of Anesthesiology, Chang Gung Memorial Hospital, Taoyuan, Taiwan
2College of Medicine, Chang Gung University, Taoyuan, Taiwan
3Division of Rheumatology, Allergy and Immunology, Chang Gung Memorial Hospital, Taoyuan, Taiwan
4Division of Rheumatology, Orthopaedics and Dermatology, University of Nottingham, Nottingham, UK
5Department of Public Health, College of Medicine, Chang Gung University, Taoyuan, Taiwan
6Biostatistics Core Laboratory, Molecular Medicine Research Center, Chang Gung University, Taoyuan, Taiwan
7Office for Big Data Research, Chang Gung Memorial Hospital, Taoyuan, Taiwan
*These authors contributed equally to this work
Huang-Ping Yu, email: [email protected]
Keywords: breast cancer, epidemiology, survival outcome, nationwide population study
Received: November 02, 2016 Accepted: January 24, 2017 Published: February 09, 2017
Breast cancer is among the most prevalent cancers in Taiwan. The National Health Insurance database was used to identify patients with breast cancer and estimate the yearly prevalence and incidence of breast cancer between 1997 and 2013. Joinpoint regression analysis was used for the annual percentage change of incidence, prevalence, and survival outcome. Among 12,181,919 female beneficiaries in 2013, the prevalence was 834.37 per 100,000 persons (95% confidence interval, 829.28–839.45) and the incidence was 93.00 per 100,000 person-year (95% confidence interval, 91.27–94.73). The average annual percentage change of the age-standardized breast cancer incidence was 3.5 per 100,000 person-years (3.1–3.8; P < 0.05), suggesting an increase in breast cancer incidence over the study period. The 5-year mortality rate was 4.5% in 1997 and 4.4% in 2008. The 5-year mortality rate among patients with Charlson comorbidity index > 1 was 39.1% (19.2%–59.1%) in 1997 and 21.1% (15.7%-32.0%) in 2008, with an annual percentage change of –0.8 (–1.3 to 2.9), suggesting that the mortality rate was gradually decreasing in patients with comorbidities. In conclusion, 1 in 120 women in Taiwan has breast cancer and the incidence is rising, while the annual percentage change of breast cancer prevalence is decreasing. The mortality rate of breast cancer was essentially stable, but the 1-year, 2-year, and 5-year mortality rates in people with Charlson comorbidity index > 1 were declined.
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