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Effects of reproductive and demographic changes on breast cancer incidence in China: A modeling analysis

Linos, Eleni and Spanos, Demetri and Rosner, Bernard A. and Linos, Katerina and Hesketh, Therese and Qu, Jian Ding and Gao, Yu-Tang and Zheng, Wei and Colditz, Graham A. (2008) Effects of reproductive and demographic changes on breast cancer incidence in China: A modeling analysis. Journal of the National Cancer Institute, 100 (19). pp. 1352-1360. ISSN 0027-8874. doi:10.1093/jnci/djn305.

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Background: Breast cancer incidence is currently low in China. However, the distribution of reproductive and lifestyle risk factors for breast cancer among Chinese women is changing rapidly. We quantified the expected effect of changes in breast cancer risk factors on future rates of breast cancer in China. Methods: We first validated and calibrated the Rosner-Colditz log-incidence breast cancer model in Chinese women who participated in the Shanghai Women's Health Study cohort (N = 74 942). We then applied the calibrated model to a representative sample of Chinese women who were aged 35-49 years in 2001 using data from the Chinese National Family Planning and Reproductive Health Survey (NFPRHS, N = 17 078) to predict the age-specific and cumulative breast cancer incidence among all Chinese women of this age group. We evaluated the relative impact of changes in modifiable risk factors, including alcohol intake, parity, postmenopausal hormone use, and adult weight gain, on cumulative incidence of breast cancer. Results: Breast cancer incidence in China is expected to increase substantially from current rates, estimated at 10-60 cases per 100 000 women, to more than 100 new cases per 100 000 women aged 55-69 years by 2021. We predicted 2.5 million cases of breast cancer by 2021 among Chinese women who were 35-49 years old in 2001. Modest reductions in hormone and alcohol use, and weight maintenance could prevent 270 000 of these cases. Conclusions: China is on the cusp of a breast cancer epidemic. Although some risk factors associated with economic development are largely unavoidable, the substantial predicted increase in new cases of breast cancer calls for urgent incorporation of this disease in future health care infrastructure planning.

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Additional Information:© The Author 2008. Published by Oxford University Press. Manuscript received January 22, 2008; revised July 8, 2008; accepted July 30, 2008. We would like to thank Dr Wanquin Wen, Dr Gabriel Leung, and Dr Irene Wong for their help in data collection. Funding for this work was provided by the National Institutes of Health grant R25 CA098566. The study sponsor had no role in study design; in the collection, analysis, or interpretation of data; in the writing of the report; or in the decision to submit the paper for publication.
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NIHR25 CA098566
Issue or Number:19
Record Number:CaltechAUTHORS:LINjnci08
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Usage Policy:No commercial reproduction, distribution, display or performance rights in this work are provided.
ID Code:13511
Deposited By: Tony Diaz
Deposited On:26 Aug 2009 17:22
Last Modified:08 Nov 2021 22:38

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