Around the world, more than 1.38 million women were diagnosed with breast cancer in 2008 with more than 458,000 women dying from the disease.
There is considerable variation in breast cancer rates between countries. Belgium and Denmark have the highest rates of breast cancer in the world with age standardized rates of 109.2 and 101.1 cases per 100,000 adult women per year respectively. A Belgian women has around a 1 in 7 chance of developing breast cancer in her lifetime. Bhutan and Mongolia have the lowest rates with just 8 cases per 100,000 women per year (although rates in these countries are almost certainly under-reported due to poor health systems).
The strongest modifiable risk factors for breast cancer are oral contraceptive and hormone replacement therapy use, alcohol consumption in excess of 2 drinks a day, not having children or having children at an older age, obesity, cigarette smoking, and a sedentary life style. As a result, breast cancer rates are highest in developed countries where the prevalence of these risk factors is much greater.
The table below shows the 15 countries with the highest age standardized rates of breast cancer. Data courtesy of GLOBOCAN 2008.
|Country||ASR (per 100,000)|
For comparison, the United States has a breast cancer rate of 76 per 100,000 women per year while Japan has a rate of 42.7 per 100,000 – one of the lowest rates in the developed world.
Uruguay is an interesting case because it is the only country in the top 15 that is considered a developing, rather than developed country. One possible explanation for the high breast cancer rate relates to diet. The typical Uruguayan diet is relatively high in fat due to a low fruit and vegetable intake and a high level of red meat consumption (Uruguay is the largest consumer of beef in the world on a per capita basis). Some studies have linked both red meat and dietary fat with an increased risk of breast cancer.
The table below shows the 15 countries with the highest age standardized breast cancer mortality rates.
|Country||ASR (per 100,000)|
Despite high incidence rates, developed countries have much lower breast cancer death rates than developing countries. While just 1 developing country appeared on the highest incidence rate list, 12 of the 15 countries on the highest mortality rate list are considered developing countries. Barbados has a mortality rate twice as high as the United States (29.2 vs 14.7 per 100,000) despite having a similar incidence rate. This underscores the huge differences in the quality of cancer care around the world. In developing countries, breast tumours tend to be picked up at a later stage due to a lack of comprehensive screening programs and poor access to healthcare facilities leading to delays in diagnosis. Treatment options are also more limited – for example, according to a 2002 report by Breast Surgery International (BSI), in more than 30 countries there is no access to radiotherapy machines at all.
Developed countries typically have 5-year breast cancer survival rates of around 90% compared to 40-60% in the developing world. 5-year breast cancer survival rates for selected countries are shown below.
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