Post on 20-Feb-2016
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Jo Anne Zujewski, MDClinical Investigations Branch
Cancer Therapy Evaluation ProgramDivision of Cancer Diagnosis and Treatment
May 2011
The Global Burden of Breast Cancer
Breast Cancer: Most common cancer in developed and
developing world• 1.38 million cases in 2008
– Most frequent cancer in women (23% of all cancers)
• Incidence – 19.3/100,000 women in East Africa– 89.7/100,000 women in Western
Europe
GLOBOCON
Breast Cancer Mortality
• 6-19 per 100,000 due to more favorable survival in (high-incidence) developed regions
• Most frequent cause of cancer death in women in both developing (269,000 deaths) and developed regions (189,000 deaths).
Thun, M. J. et al. Carcinogenesis 2010 31:100-110; doi:10.1093/carcin/bgp263
Number and distribution of cancer cases by level of economic development and year (assuming no change in the annual incidence rate)
Breast Cancer Rates are Rising…
• ‘Westernization' of lifestyles• Urbanization• Dietary habits and physical inactivity• Changes in reproductive factors such as
lower rates of childbearing • Exposure to exogenous estrogen
Cancers in Women: Uzbekistan
Uzbekistan
Incidence 19.2/100,000 (2174 cases)
Mortality 10.2/100,000 (1111 deaths)
How effective is therapy for breast cancer?
stage 5 year survival
0 93 %I 88 %IIA 81 %IIB 74 %IIIA 67 %IIIB 41 %IIIC 49 %IV 15 %
years 5 year survival
1974-1976 75 %1983-1985 78 %1992-1997 86 %1995-2003 89 %
National Cancer Data Basebreast cancer diagnosis 2001 and 2002.
SEER, 1973-2003, DCP, NCI, 2009
Breast cancer rates increasing- approaches
require: • Guidelines that are evidence-based,
economically feasible, and culturally appropriate
• Early detection - metastatic disease is not treated successfully in ANY country
• Improved cancer registries and data collection
• Clinical trials in developing countries