Breast cancer mortality trends in Europe among women in perimenopausal and postmenopausal age (45+)

Introduction: The aim of the study was to analyze breast cancer (BC) mortality trends among women at the age of 45 years old and older (45+) in the 28 European Union (EU) countries, as well as in 3 non-EU countries - Norway, Switzerland and the Russian Federation (control group) within the period 1959-2017. Material and methods: Mortality and population data were sourced from the World Health Organization (WHO) database, and age-standardized mortality rates were calculated using the standard world population. Changes in mortality trends were analyzed using Joinpoint Trend Analysis Software. Results: The majority of analyzed countries showed a meaningful decrease in BC mortality among women aged 45+. However, the results of our study suggest that there are 4 EU countries - Croatia, Poland, Romania and Slovakia - where increasing BC mortality trends started to be visible in the analyzed age group. Currently, the observed increase is still not significant, but the obtained data suggest the possibility of further continuation of the observed trend in the future. Moreover, in Bulgaria we also noted continuation of the increase in BC mortality (statistically significant). Conclusions: Due to the availability of better treatment options, as well as presence of effective tools for detecting BC at the early stages of progression, BC mortality is falling in most analyzed European countries. To maintain this situation and to stop BC mortality increase in the analyzed age group in Bulgaria, Croatia, Poland, Romania and Slovakia, immediate actions for improvement of BC management in the European health care systems should be considered.