Breast cancer incidence statistics

Breast cancer has been the most common cancer in the UK since 1997, despite the fact that it is rare in men. It is by far the most common cancer among women in the UK (2010), accounting for 31% of all new cases of cancer in females.1-4

In 2010, there were 49,961 new cases of breast cancer in the UK (Table 1.1): 49,564 (99%) in women and 397 (less than 1%) in men, giving a female:male ratio of around 125:1.1-4 The crude incidence rate shows that there are 157 new breast cancer cases for every 100,000 females in the UK, and 1 for every 100,000 males.

European age-standardised incidence rates (AS rates) are significantly lower in Northern Ireland than in England, Wales or Scotland (females only) (Table 1.1). Rates do not differ significantly between the other constituent countries of the UK for women or men. The pattern of the lowest rates being recorded in Northern Ireland has been consistent for almost two decades.5 Scotland is the only nation in the UK where breast cancer is not the most common cancer overall; there lung cancer is more common.1-4

Table 1.1: Breast Cancer (C50), Number of New Cases, Crude and European Age-Standardised (AS) Incidence Rates per 100,000 Population, UK, 2010

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*95% LCL and 95% UCL are the 95% lower and upper confidence limits around the AS Rate

There was little geographical variation in breast cancer incidence in the 1990s, with slightly higher rates in some areas of south England (except London) and slightly lower rates in the far north of England.6 The latest analysis of breast cancer incidence rates throughout the UK reports only modest variation between most cancer networks, but notably higher rates in parts of south England and south-east Scotland, and lower rates in parts of London.7,8

section reviewed 07/11/12
section updated 07/11/12

Female breast cancer incidence is strongly related to age, with the highest incidence rates overall being in older women, supporting a link with hormonal status. By the age of 50 around 10,000 women were diagnosed with breast cancer (in the UK in 2010), but 80% of all diagnoses were in the over 50s, and 45% were diagnosed in women aged 65 and over (in the UK between 2008 and 2010; (Figure 1.1).1-4 Age-specific incidence rates rise steeply from around age 35-39, level off for women in their 50s, then rise further to age 65-69, drop slightly for women aged 70-74, then increase steadily to reach an overall peak in the 85+ age group (Figure 1.1).1-4 The peaks and troughs of incidence for women aged 50 and over may partly be explained by the impact of screening for breast cancer.

Figure 1.1: Breast Cancer (C50), Average Number of New Cases per Year and Age-Specific Incidence Rates, Females, UK, 2008-2010

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Nearly half (48%) of female breast cancer cases are diagnosed in the 50-69 age group (Figure 1.1);1-4 currently women in this age group and those aged 70 are invited for screening every three years in the UK through the NHS Breast Screening Programme.9 In England a trial is taking place to look at the possible benefits of extending breast screening so that women aged 47 to 50 and 70 to 73 are also invited.

Although very few cases of breast cancer occur in women in their teens or early 20s, breast cancer is the most commonly diagnosed cancer in women aged under 39. Among women aged 35-39 in the UK, around 1,350 cases of breast cancer are diagnosed each year.

section reviewed 03/05/13
section updated 03/05/13

Female breast cancer incidence rates have overall increased in Great Britain since the mid-1970s (Figure 1.2).1-3 European AS incidence rates increased by 72% between 1975-1977 and 2008-2010. Incidence rates initially increased steadily by around 1-2% per annum from the mid-1970s.1-3,5 The introduction of national screening programmes from the late 1980s led to a transient additional increase in incidence as a prevalent pool of undiagnosed cancers were detected in the population. By the mid-1990s, the increase in incidence rates returned to the pre-screening pace and continued this way until around the mid-2000s, after which time incidence rates have remained relatively stable (Figure 1.2).1-3

Figure 1.2: Breast Cancer (C50), European Age-Standardised Incidence Rates, Females, Great Britain, 1975-2010

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Female breast cancer incidence trends for the UK are shown in Figure 1.3.1-4 Over the last decade (between 1999-2001 and 2008-2010), the European AS incidence rate has increased by 6%, with almost this entire rise occurring before the mid-2000s.

Figure 1.3: Breast Cancer (C50), European Age-Standardised Incidence Rates, Females, UK, 1993-2010

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Female breast cancer incidence rates have overall increased for all broad age groups in Great Britain since the mid-1970s (Figure 1.4).1-3 The largest increases have been in women aged 65-69 and 50-64, with European AS incidence rates approximately doubling (109% and 97% increases, respectively) between 1975-1977 and 2008-2010. The trends by age-group show clearly that the steeper increase in incidence in the late 1980s and early 1990s was largely confined to women aged 50-64 (the age group for screening when the programmes began) (Figure 1.4). The most recent rates show a slight downturn for this age-group. Similarly, the recent steep rise in rates for women aged 65-69 is almost certainly caused by the extension of the breast screening programmes to include this age group, which started in 2001 (Figure 1.4).1-3

Figure 1.4: Breast Cancer (C50), European Age-Standardised Incidence Rates, Females, by Age, Great Britain, 1975-2010

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The trends in breast cancer incidence are most likely to be associated with the declining use of hormone replacement therapy (HRT), which has been shown to increase the risk of breast cancer in some women.10,11

A similar steep decrease in incidence was seen since 2002 for women aged 50 or older in the USA. This was linked to the sudden drop in HRT use following publication of the Women's Health Initiative (WHI) Trial results.12-15

The WHI trial was a randomised controlled trial of oestrogen-plus-progestin use in post-menopausal women for prevention of chronic disease. The trial was stopped early in July 2002 because risks exceeded benefits. The most recent WHI study reports that the decrease in breast cancer incidence in the over 50s is most likely to be due to the reduced use of HRT rather than decreased uptake of screening and also that the risk of breast cancer after stopping HRT seems to fall very quickly.16

Similar trends have been seen in other countries.17 In Scotland an analysis of breast cancer incidence and HRT use also reports a reduction in incidence for women aged 50-64 and a dramatic decrease in HRT use consistent with this theory (Figure 1.5).18 This analysis also showed a gradual increase since 1999 in prescriptions of raloxifene – a selective oestrogen receptor modulator that has been shown to reduce risk of oestrogen-receptor-positive breast cancer and is also used to treat osteoporosis.19

Rates of HRT use in the UK rose steeply from 1992 to peak in 2000-2001, with approximately 25% of women aged 45-69 using HRT; by 2006, this percentage had halved.20 It has been estimated that 1,400 fewer cases of breast cancer were diagnosed in women aged 50-59 in the UK in 2005 than would have occurred if HRT use had not declined.19

Figure 1.5: European Age-Standardised Incidence Rates of Invasive Breast Cancer, by Age Group, in Scottish Women (1980-2005) and Numbers of Dispensed Items of HRT and Raloxifene (1993-2005)

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section reviewed 07/11/12
section updated 07/11/12

Lifetime risk is an estimation of the risk that a newborn child has of being diagnosed with cancer at some point during their life. It is a summary of risk in the population but genetic and lifestyle factors affect the risk of cancer and so the risk for every individual is different.

In 2010, in the UK, the lifetime risk of developing breast cancer is 1 in 8 for women and 1 in 868 for men.21

The lifetime risk for breast cancer has been calculated by the Statistical Information Team using the ‘Adjusted for Multiple Primaries’ (AMP) method; this accounts for the possibility that someone can have more than one diagnosis of breast cancer over the course of their lifetime.22

section reviewed 25/04/13
section updated 25/04/13

Almost a quarter (24%) of all female breast cancer cases in Great Britain between 2008 and 2010 occurred in the upper-outer quadrant of the breast (ICD-10 C50.4). A further 7% were in the upper-inner quadrant (ICD-10 C50.2), and 6% were classified as overlapping more than one region of the breast (ICD-10 C50.8). Almost half (48%) of the cases did not have the specific part of the breast affected recorded in cancer registry data.1-3

section reviewed 07/11/12
section updated 07/11/12

Data on around 17,800 women diagnosed with breast cancer in the East of England in 2006-2009 shows that, of the 92% of cancers for which a stage was recorded, 41% were Stage I, 45% stage II, 9% stage III and 5% stage IV.23

section reviewed 07/11/12
section updated 07/11/12

Although cancer registration has a long history in many countries of the world, particularly in the more affluent regions such as the UK, nearly 80% of the world’s populations live in regions that are not covered by such systems.24 Nonetheless, with a view to characterising the global burden of the disease, the International Agency for Research on Cancer routinely uses the available data to estimate worldwide cancer incidence.25

Breast cancer is by far the most common cancer diagnosed in women worldwide, with an estimated 1.38 million new cases diagnosed in 2008 (around 23% of the total in women only, and around 11% of the total in men and women together). Female breast cancer incidence rates are highest in Western Europe and lowest in Eastern and Middle Africa, with nearly five-fold variation in World AS incidence rates between the regions of the world (Figure 1.6).25

Figure 1.6: Breast Cancer (C50), World Age-Standardised Incidence Rates, Females, World Regions, 2008 Estimates

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Female breast cancer incidence has been increasing for many years in economically developed regions of the world;11,26 and now rates in central and eastern Europe and the Far East, which have historically been comparatively low, have begun to rise rapidly.27-29 These increases have been linked to lifestyle changes, for example in reproductive behaviour, weight gain, alcohol consumption and the use of HRT.30 Accordingly, in populations of women who migrate from low to high risk countries breast cancer rates typically increase rapidly to reach those of the local population, suggesting a strong effect for lifestyle or environmental factors.31,32

Within the 27 countries of the European Union, the highest female breast cancer European AS incidence rates for 2008 are estimated to be in Belgium (around 145 cases per 100,000); the lowest rates are estimated to be in Greece (around 57 cases per 100,000) (Figure 1.7).

Figure 1.7: Breast Cancer (C50), European Age-Standardised Incidence Rates, Females, EU27 Countries, 2008 Estimates

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UK female breast cancer incidence rates are estimated to be the 6th highest in Europe (EU-27).22

section reviewed 07/11/12
section updated 07/11/12

Female breast cancer incidence is strongly related to deprivation; it is one of the few cancers where incidence rates are lower for more deprived women and there is a clear trend of decreasing rates from least to most deprived women.33 The most recent England-wide data for 2000-2004 shows European AS incidence rates are around 25% higher for women living in the least deprived areas compared with the most deprived.34 It has been estimated that there would have been an additional 2,500 new breast cancer cases each year in England during 2000-2004 if all women experienced the same rates as the most affluent.34

A study in Scotland for 2005-2009 showed that the gap in breast cancer incidence is slightly lower, with the least deprived women having around 11% higher rates compared with the most deprived.35 Similar clear associations with deprivation have also been reported in Wales and Northern Ireland.36-37

These results are not unexpected as many breast cancer risk factors – for example, late first pregnancy, lower parity, and HRT use – are generally more prevalent in more affluent populations.38

section reviewed 07/11/12
section updated 07/11/12

Prevalence refers to the number of people who have previously received a diagnosis of cancer and who are still alive at a given time point. Some patients will have been cured of their disease and others will not.

In the UK around 296,000 women were still alive at the end of 2006, up to ten years after being diagnosed with breast cancer (Table 1.2).39

Table 1.2: Breast Cancer (C50), One, Five and Ten Year Cancer Prevalence, UK, 31st December 2006

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Worldwide, it is estimated that there were around 5.19 million women still alive in 2008, up to five years after their diagnosis.25

section reviewed 09/05/13
section updated 09/05/13

In 2010, 397 men were diagnosed with breast cancer in the UK (Table 1.1). Among men, breast cancer accounts for less than 1% of cancer cases.1-3

Breast cancer incidence in males is strongly related to age. In the UK between 2008 and 2010, an average of 66% of male breast cancer cases were in men aged 65 years and over (Figure 1.8).1-4

Figure 1.8: Breast Cancer (C50), Average Number of New Cases per Year and Age-Specific Incidence Rates, Males, UK, 2008-2010

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Breast cancer incidence rates for men have changed very little since the late 1970s in Great Britain (Figure 1.9).1-3

Figure 1.9: Breast Cancer (C50), European Age-Standardised Incidence Rates, Males, Great Britain, 1979-2010

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The latest prevalence estimates for the UK (Table 1.2) show that around 1,700 men were still alive at the end of 2006, up to ten years after being diagnosed with breast cancer.39

section reviewed 07/11/12
section updated 07/11/12