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000157708 1001_ $$0P:(DE-He78)bbfe0ebad1e3b608bca2b49d4f86bd09$$aJansen, Lina$$b0$$eFirst author
000157708 245__ $$aDivergent Patterns and Trends in Breast Cancer Incidence, Mortality and Survival Among Older Women in Germany and the United States.
000157708 260__ $$aBasel$$bMDPI$$c2020
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000157708 520__ $$aBreast cancer treatment has changed tremendously over the last decades. In addition, the use of mammography screening for early detection has increased strongly. To evaluate the impact of these developments, long-term trends in incidence, mortality, stage distribution and survival were investigated for Germany and the United States (US).Using population-based cancer registry data, long-term incidence and mortality trends (1975-2015), shifts in stage distributions (1998-2015), and trends in five-year relative survival (1979-2015) were estimated. Additionally, trends in five-year relative survival after standardization for stage were explored (2004-2015).Age-standardized breast cancer incidence rates were much higher in the US than in Germany in all periods, whereas age-standardized mortality began to lower in the US from the 1990s on. The largest and increasing differences were observed for patients aged 70+ years with a 19% lower incidence but 45% higher mortality in Germany in 2015. For this age group, large differences in stage distributions were observed, with 29% (Germany) compared to 15% (US) stage III and IV patients. Age-standardized five-year relative survival increased strongly between 1979-1983 and 2013-2015 in Germany (+17% units) and the US (+19% units) but was 9% units lower in German patients aged 70+ years in 2013-2015. This difference was entirely explained by differences in stage distributions.Overall, our results are in line with a later uptake and less extensive utilization of mammography screening in Germany. Further studies and efforts are highly needed to further explore and overcome the increased breast cancer mortality among elderly women in Germany.
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000157708 7001_ $$aHolleczek, Bernd$$b1
000157708 7001_ $$aKraywinkel, Klaus$$b2
000157708 7001_ $$0P:(DE-HGF)0$$aWeberpals, Janick$$b3
000157708 7001_ $$0P:(DE-HGF)0$$aSchröder, Chloé Charlotte$$b4
000157708 7001_ $$aEberle, Andrea$$b5
000157708 7001_ $$aEmrich, Katharina$$b6
000157708 7001_ $$aKajüter, Hiltraud$$b7
000157708 7001_ $$00000-0003-0490-1554$$aKatalinic, Alexander$$b8
000157708 7001_ $$aKieschke, Joachim$$b9
000157708 7001_ $$aNennecke, Alice$$b10
000157708 7001_ $$aSirri, Eunice$$b11
000157708 7001_ $$00000-0002-4684-9099$$aHeil, Jörg$$b12
000157708 7001_ $$aSchneeweiss, Andreas$$b13
000157708 7001_ $$0P:(DE-He78)90d5535ff896e70eed81f4a4f6f22ae2$$aBrenner, Hermann$$b14$$eLast author
000157708 773__ $$0PERI:(DE-600)2527080-1$$a10.3390/cancers12092419$$gVol. 12, no. 9, p. 2419 -$$n9$$p2419$$tCancers$$v12$$x2072-6694$$y2020
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