Incidence trends of breast cancer in Saudi Arabia: A joinpoint regression analysis (2004-2016)

Objectives: To report the burden of breast cancer among Saudi females from 2004 to 2016. Methods: Age-standardised rates and cases according to age, year, region and stage at diagnosis were retrieved from the Saudi Cancer Registry (SCR). Descriptive statistics were reported before joinpoint regression analysis was used to calculate the annual percent change (APC). Results: During the study period, the number of breast cancer cases increased by 186% from 783 cases in 2004 to 2240 cases in 2016. The median age at diagnosis increased from 47 to 50 years (APC = + 0.7, 95% CI = 0.5 to 0.9) and nearly 60% of cases were diagnosed among women aged >40 years. During the study period, the percentage of localised cases increased by 17% (APC = +5.1, 95% CI = 8.7 to 3.3), along with a reduction in regional (APC =-1.3, 95% CI =-0.4 to-4.9) and unknown (APC =-6.5, 95% CI =-12.0 to-0.7) cases. The highest increases in breast cancer cases were recorded in Najran (APC = +8.8, 95% CI = 0.7 to 17.5), followed by Qassim (APC = +6.9, 95% CI = 2.4 to 11.6) and Hail (APC = +6, 95% CI = 3.0 to 9.1). Makkah region reported the lowest significant increase with an APC of +2.3 (95% CI = 0.3 to 4.4) per year. Conclusion: Although an increasing trend in breast cancer cases were seen over the study period, encouraging outcomes were observed. An incidence shift towards the older age group was noticed, as well as an increased proportion of women diagnosed at early stages. A higher APC was seen in smaller regions, which highlights the need for region-based studies. (c) 2021 The Authors. Published by Elsevier B.V. on behalf of King Saud University. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).