Gemma Jacklyn1, Stephen Morrell2, Kevin McGeechan3, Nehmat Houssami3, Les Irwig3, Nirmala Pathmanathan4, Alexandra Barratt5. 1. Wiser Healthcare, Sydney School of Public Health, The University of Sydney, NSW, 2006, Australia. Electronic address: gemma.jacklyn@sydney.edu.au. 2. School of Public Health and Community Medicine, Faculty of Medicine, University of New South Wales, Sydney, NSW, 2052, Australia. 3. Sydney School of Public Health, The University of Sydney, NSW, 2006, Australia. 4. Sydney Medical School - Westmead, The University of Sydney, Westmead, NSW, 2145, Australia; Westmead Breast Cancer Institute, Westmead Hospital, Westmead, NSW, Australia. 5. Wiser Healthcare, Sydney School of Public Health, The University of Sydney, NSW, 2006, Australia.
Abstract
BACKGROUND: The incidence of non-invasive breast cancer has increased substantially over time. We aim to describe temporal trends in the incidence of carcinoma in situ of the breast in New South Wales (NSW), Australia. METHODS: Descriptive study of trends in the incidence of ductal carcinoma in situ (DCIS) and lobular carcinoma in situ (LCIS) in women who received a diagnosis from 1972 to 2012, recorded in the NSW Cancer Registry. RESULTS: Carcinoma in situ as a proportion of all breast cancer was 0.4% during the prescreening period 1972 to 1987 and is currently 14.1% (2006 to 2012). Among 10,810 women diagnosed with DCIS, incidence across all ages rose from 0.15 per 100,000 during 1972 to 1983 to 16.81 per 100,000 over 2006 to 2012, representing a 100-fold increase (IRR 113.10; 95% CI 81.94 to 156.08). Among women in the target age group for screening (50-69 years) incidence rose from 0.27 per 100,000 to 51.96 over the same period (IRR 195.50; 95% CI 117.26 to 325.89). DCIS incidence peaks in women aged 60-69 years. DCIS incidence has not stabilized despite screening being well established for over 20 years, and participation rates in the target age range remaining stable. CONCLUSIONS: Our findings raise questions about the value of the increasing detection of DCIS and aggressive treatment of these lesions, especially among older women, and support trials of de-escalated treatment.
BACKGROUND: The incidence of non-invasive breast cancer has increased substantially over time. We aim to describe temporal trends in the incidence of carcinoma in situ of the breast in New South Wales (NSW), Australia. METHODS: Descriptive study of trends in the incidence of ductal carcinoma in situ (DCIS) and lobular carcinoma in situ (LCIS) in women who received a diagnosis from 1972 to 2012, recorded in the NSW Cancer Registry. RESULTS:Carcinoma in situ as a proportion of all breast cancer was 0.4% during the prescreening period 1972 to 1987 and is currently 14.1% (2006 to 2012). Among 10,810 women diagnosed with DCIS, incidence across all ages rose from 0.15 per 100,000 during 1972 to 1983 to 16.81 per 100,000 over 2006 to 2012, representing a 100-fold increase (IRR 113.10; 95% CI 81.94 to 156.08). Among women in the target age group for screening (50-69 years) incidence rose from 0.27 per 100,000 to 51.96 over the same period (IRR 195.50; 95% CI 117.26 to 325.89). DCIS incidence peaks in women aged 60-69 years. DCIS incidence has not stabilized despite screening being well established for over 20 years, and participation rates in the target age range remaining stable. CONCLUSIONS: Our findings raise questions about the value of the increasing detection of DCIS and aggressive treatment of these lesions, especially among older women, and support trials of de-escalated treatment.
Authors: Serdar Altinay; Laurent Arnould; Noella Bletard; Cecile Colpaert; Franceska Dedeurwaerdere; Benjamin Dessauvagie; Valérie Duwel; Giuseppe Floris; Stephen Fox; Clara Gerosa; Shabnam Jaffer; Eline Kurpershoek; Magali Lacroix-Triki; Andoni Laka; Kathleen Lambein; Gaëtan Marie MacGrogan; Caterina Marchió; Dolores Martin Martinez; Sharon Nofech-Mozes; Dieter Peeters; Alberto Ravarino; Emily Reisenbichler; Erika Resetkova; Souzan Sanati; Anne-Marie Schelfhout; Vera Schelfhout; Abeer M Shaaban; Renata Sinke; Claudia Maria Stanciu-Pop; Claudia Stobbe; Carolien H M van Deurzen; Koen Van de Vijver; Anne-Sophie Van Rompuy; Stephanie Verschuere; Anne Vincent-Salomon; Hannah Wen; Hélène Dano; Caroline Bouzin; Christine Galant; Mieke R Van Bockstal Journal: Mod Pathol Date: 2019-09-18 Impact factor: 7.842