Breast cancer diagnosis and death in the Netherlands: a changing burden.

BACKGROUND Lifetime risks are often used in communications on cancer to the general public. The most-cited estimate for breast cancer risk (1 in 8 women), however, appears to be outdated. Here we describe the breast cancer burden in the Netherlands over time by means of lifetime and age-conditional risks. The aim is to identify changes in absolute risk of primary breast cancer diagnosis and death. METHODS Data on breast cancer incidence, mortality and size of the female population were retrieved from the Netherlands Cancer Registry and Statistics Netherlands. Lifetime and age-conditional risks were calculated for 1990, 2000 and 2010 using the life-table method (DevCan software). RESULTS The lifetime risk of developing breast cancer (ductal carcinoma in situ and invasive) in 1990, 2000 and 2010 was estimated at 10.8 (1 in 9.3 women), 13.5 (1 in 7.4) and 15.2% (1 in 6.6), respectively. Most women were still diagnosed after the age of 50, with the highest risk between 60 and 70 years in 2010. The lifetime risk of breast cancer death was 3.8% (1 in 27) in 2010, which is lower than in 1990 (4.5%; 1 in 22) and 2000 (4.2%; 1 in 24). CONCLUSION Breast cancer risk has increased to 1 in 6.6 women being diagnosed during their lifetime (invasive cancer only: 1 in 7.4), whereas risk of breast cancer death has decreased from 1 in 22 to 1 in 27 women. To keep cancer management and prevention up-to-date, it remains important to closely monitor the ever-changing breast cancer burden.