Distinct temporal trends in breast cancer incidence from 1997 to 2016 by molecular subtypes: a population-based study of Scottish cancer registry data

Abstract

Background We describe temporal trends in breast cancer incidence by molecular subtypes in Scotland because public health prevention programmes, diagnostic and therapeutic services are shaped by differences in tumour biology. Methods Population-based cancer registry data on 72,217 women diagnosed with incident primary breast cancer from 1997 to 2016 were analysed. Age-standardised rates (ASR) and age-specific incidence were estimated by tumour subtype after imputing the 8% of missing oestrogen receptor (ER) status. Joinpoint regression and age–period–cohort models were used to assess whether significant differences were observed in incidence trends by ER status. Results Overall, ER-positive tumour incidence increased by 0.4%/year (95% confidence interval (CI): −0.1, 1.0). Among routinely screened women aged 50–69 years, we observed an increase in ASR from 1997 to 2011 (1.6%/year, 95% CI: 1.2–2.1). ER-negative tumour incidence decreased among all ages by 2.5%/year (95% CI: −3.9 to −1.1%) over the study period. Compared with the 1941–1959 birth cohort, women born in 1912–1940 had lower incidence rate ratios (IRR) for ER+ tumours and women born in 1960–1986 had lower IRR for ER− tumours. Conclusions Future incidence and survival reporting should be monitored by molecular subtypes to inform clinical planning and cancer control programmes.