Epidemiology of breast cancer in the city of Nis, Serbia.
OBJECTIVE
Over the past 10 years, Serbia has been affected by a heavy economic and political crisis that in 1999 even led to war and bombardment. Numerous facts indicate that the crisis has resulted in low-level health protection, increasing mortality, as well as other deteriorating effects over the general health of the population. The aim of the study was to assess mortality trends in female breast cancer in the city of Nis prior to (1986-1993) and following (1995- 1999) the socio-economic crisis peak.


METHODS
Population and hospital cancer registry data for the 1986-1999 period were used for analysis, as well as death certificate data for all women who lived and died in the city of Nis in the given period. Survival was calculated according to the Kaplan-Meier method. The rates were calculated per 100,000 inhabitants (1991 census) and were not standardized.


RESULTS
A total of 455 women in the city of Nis died of breast cancer during 1986-1999. The polynomial trend in mortality revealed an increasing (1986-1992) and decreasing (1993-1996) tendency, although the first period showed a lower average mortality (28.7) than did the second one (30.45). Survival rates were calculated for the periods 1986- 1993 and 1995-1998. The 12-month survival rate was 84.7% in the first and 92% in the second period; the 24-month survival rate for the first period was 76.6% and 87.9% for the second; the 36-month survival was 67.7% in the first and 80.5% in the second period; the 4-year survival rate for 1986-1993 was 64.1% and 78.1% for 1995-1999.


CONCLUSIONS
The socio-economic and political crisis has proved to affect breast cancer patients in Serbia. Overall, the mortality rate increased. Calculated upon division of the whole period into two, mortality shows an upward trend in the first period (1986-1992) and a downward trend in the second. Although 1993-1999 was more difficult for the Serbian and Yugoslavian population (manifested in the therapy of all diseases, including breast cancer), the diagnosis of breast cancer improved and the disease was detected at earlier stages, the result of which were better survival rates in the 1986-1992 period.
Petrović
B
B
Institute for Public Health, Department of Epidemiology, University Clinical Center, Nis, Yugoslavia.
Kocić
B
B
Filipović
S
S
Rancić
N
N
Filipović
A
A