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The Global Burden of Breast Cancer. Jo Anne Zujewski, MD Clinical Investigations Branch Cancer Therapy Evaluation Program Division of Cancer Diagnosis and Treatment May 2011. Breast Cancer: Most common cancer in developed and developing world. 1.38 million cases in 2008
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The Global Burden of Breast Cancer Jo Anne Zujewski, MD Clinical Investigations Branch Cancer Therapy Evaluation Program Division of Cancer Diagnosis and Treatment May 2011
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).
Number and distribution of cancer cases by level of economic development and year (assuming no change in the annual incidence rate) Thun, M. J. et al. Carcinogenesis 2010 31:100-110; doi:10.1093/carcin/bgp263
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
Berry D.A., et al. N Engl J Med. 353:1784-92, 2005 Decrease in breast cancer mortality
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? SEER, 1973-2003, DCP, NCI, 2009 National Cancer Data Base breast cancer diagnosis 2001 and 2002.
Incremental Benefit chemoTx + antiER + targeted chemoTx + antiER mastectomy No surgery
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