Breast and cervical cancer in 187 countries between 1980 and 2010: a systematic analysis
A partir des données des registres de 187 pays, cette analyse systématique rend compte de l'incidence des cancers du sein et de col de l'utérus ainsi que de la mortalité sur la période 1980-2010
Breast and cervical cancer are important causes of mortality in women aged ?15 years. We undertook annual age-specific assessments of breast and cervical cancer in 187 countries. We systematically collected cancer registry data on mortality and incidence, vital registration, and verbal autopsy data for the period 1980?2010. We modelled the mortality-to-incidence (MI) ratio using a hierarchical model. Vital registration and verbal autopsy were supplemented with incidence multiplied by the MI ratio to yield a comprehensive database of mortality rates. We used Gaussian process regression to develop estimates of mortality with uncertainty by age, sex, country, and year. We used out-of-sample predictive validity to select the final model. Estimates of incidence with uncertainty were also generated with mortality and MI ratios. Global breast cancer incidence increased from 641?000 (95% uncertainty intervals 610?000?750?000) cases in 1980 to 1?643?000 (1?421?000?1?782?000) cases in 2010, an annual rate of increase of 3·1%. Global cervical cancer incidence increased from 378?000 (256?000?489?000) cases per year in 1980 to 454?000 (318?000?620?000) cases per year in 2010?a 0·6% annual rate of increase. Breast cancer killed 425?000 (359?000?453?000) women in 2010, of whom 68?000 (62?000?74?000) were aged 15?49 years in developing countries. Cervical cancer death rates have been decreasing but the disease still killed 200?000 (139?000?276?000) women in 2010, of whom 46?000 (33?000?64?000) were aged 15?49 years in developing countries. We recorded pronounced variation in the trend in breast cancer mortality across regions and countries. More policy attention is needed to strengthen established health-system responses to reduce breast and cervical cancer, especially in developing countries. Susan G Komen for the Cure and the Bill & Melinda Gates Foundation.
The Lancet , résumé, 2010