Remarkable change in age-specific breast cancer incidence in the Swiss canton of Geneva and its possible relation with the use of hormone replacement therapy.
BACKGROUND
This article aims to explain the reasons for the remarkable change in age of breast cancer occurrence in the Swiss canton of Geneva.


METHODS
We used population-based data from the Geneva cancer registry, which collects information on method of detection, stage and tumour characteristics since 1975. For patients diagnosed between 1997-2003, we obtained additional information on use of hormone replacement therapy from a large prospective study on breast cancer. Using generalized log linear regression analysis, we compared age-specific incidence rates with respect to period, stage, oestrogen receptor status, method of detection and use of hormone replacement therapy.


RESULTS
In the periods 1975-1979 and 1985-1989, breast cancer risk increased with age, showing the highest incidence rates among women aged >or= 85 years. From 1997, the age-specific incidence curve changed completely (p < 0.0001), showing an incidence peak at 60-64 years and a reduced incidence among elderly women. This incidence peak concerned mainly early stage and oestrogen positive cancers and was exclusively observed among women who ever used hormone replacement therapy, regardless whether the tumour was screen-detected or not.


CONCLUSIONS
The increasing prevalence of hormone replacement therapy use during the 1990s could explain the important change in age-specific breast cancer incidence, not only by increasing breast cancer risk, but also by revealing breast cancer at an earlier age.
Geneva Cancer Registry, Institute for Social and Preventive Medicine, Geneva University, 55 boulevard de la Cluse, 1205 Geneva, Switzerland. christine.bouchardymagnin@imsp.unige.ch
Christine
C
Bouchardy
Alfredo
A
Morabia
Helena M
HM
Verkooijen
Gérald
G
Fioretta
Yves
Y
Wespi
Peter
P
Schäfer
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000175:diagnosis / Q000453:epidemiology*; D002648:Child; D002675:Child, Preschool; D020249:Hormone Replacement Therapy / Q000009:adverse effects*; D006801:Humans; D015994:Incidence; D007223:Infant; D008875:Middle Aged; D013557:Switzerland / Q000453:epidemiology