Incidence,mortality and survival of female breast cancer during 2003-2011 in Jiangsu province,China

Objective： To assess the incidence, mortality and survival status of female breast cancer in Jiangsu province of China. Methods： Population-based cancer registry data in Jiangsu province were collected during 2003-2011. Crude rates, age-specific rates, age-standardized rates and annual percent changes of incidence and mortality were calculated to describe the epidemiologic characteristics and time trends. Patients diagnosed from 2003 to 2005 were chosen for analyzing the survival status of breast cancer. Results： From 2003 to 2011, 17,605 females were diagnosed with breast cancer and 4,883 died in selected registry areas in Jiangsu province. The crude incidence rate was 25.18/100,000, and the age-standardized rates by Chinese population （ASRC） and by world population （ASRW） were 19.03/100,000 and 17.92/100,000, respectively. During the same period, the crude mortality rate was 6.98/100,000 and the ASRC and ASRW were 4.93/100,000 and 4.80/100,000, respectively. From 2003 to 2011, the incidence and mortality increased with annual percent change of 11.37% and 5.78%, respectively. For survival analysis, 1,392 patients in 7 areas were identified in 2003-2005 and finished 5 years of follow-up. Survival rates were found to decrease with survival years, the 5-year observed survival rate was 45.9% and the relative survival rate was 52.0%. We also found that the survival rate varied across the province, which was lower in the north and higher in the south of Jiangsu province. Conclusions： Breast cancer has become a significant public health problem in Jiangsu province and China. More resources should be invested in primary prevention, earlier diagnosis and better health services in order to increase survival rates among Chinese females.

COMPARISON OF SURVIVAL AMONG PATIENTS WITH BREAST CANCER TREATED AT FIRST TEACHING HOSPITAL,CHANGCHUN,CHINA,AND SAINTSACREMENT HOSPITAL,QUBEC,CANADA

The aim of this study was to compare the survival of 116 patients with breast cancer initially treated at the First Teaching Hospital (FTH) of Norman Bethune University of Metlical Sciences located in Changchun, China, from 1986 to 1991 with the survival of 886 patients sesn in the 'HōPital du Saint-Sacrenient' (HSS) located in Quehec City, Canada, from 1987 to 1992.The clinical data were collected from the hospital records at FTH.The vital status for Chinese Patients was obtained from letters of follow-up or the records of local police offices.The list of Patients treated at HSS and the data for each woman were extracted from computerized data banks.The major variables studied included age at diagnosis, tumor size at pathology(cm),number of lymph nodes involved,breast surgery and adjuvant treatments of breast cancer (chemotherapy,radiotherapy,immunotherapy).Age at diagnosis was substantially lower among patients with breast cancer seen at FTH compared to those treated at HSS (x_1￣2= 60.95,P<0.0001). The average age at diagnosis for Chinese women was about 10 years less than that for Canadian women. Patients in the two hospitals differed with respect to tumor size at pathology (x_2￣2 =6.67,P=0.036). The proportion of patients with tumor size larger than 2.0 cm was larger at FTH (48.3%) than at HSS (41.1%). The mean tumor size at pathology was 3.0 cm (standard deviation= 2.l cm) for patients treated at FTH, but 2.6 cm (standard deviation=1.8 cm) for women treated at HSS (P=0.07).The proportion of women with lymph node involvement was greater at FTH (61.1 % than that at HSS (37.3%) (x_1￣2 = 16.5l,P<0.0001 ).Surgical treatment of breast cancer varied considerably. In Changchun,radical mastectomy was frequent for any stage of breast cancer patients,hut partial mastectomy was never performed. The situation was reversed in Québec.The five year observed survival was 74.2% (standard error, 0.05) among breast cancer patients seen at FTH compared to 76.0% (standard error, 0.02) among women treated at HSS.After adjustments of confounding factors, there were no significant difference in five year observed survival between the patients treated at the two hospitals (P=0.42).