title: Breast cancer mortality in Russia and Ukraine 1963-2002: an age-period-cohort analysis.
abstract: OBJECTIVE
  To determine the reasons for the steady increase in breast cancer mortality in Russia and Ukraine.
  
  
  METHODS
  Age-period-cohort analysis, supplemented by analysis of historical fertility trends.
  
  
  RESULTS
  Mortality from breast cancer has risen steadily in both countries over the past 40 years, although faster in Russia than in Ukraine. There are strong birth cohort effects, which are consistent with known changes in fertility. Death rates were highest among those born in the first half of the 20th century, declining among those born after the 1950s. There has been a decline in mortality among younger women since the mid 1990s, which may reflect improvements in treatment.
  
  
  CONCLUSIONS
  The increase in breast cancer mortality in Russia and Ukraine can largely be explained by known changes in fertility, while recent changes may reflect changes in treatment. Observed trends suggest that death rates from female breast cancer in the two countries are likely to stabilize or even decline in the future.
authors.affiliation: European Centre on Health of Societies in Transition, London School of Hygiene and Tropical medicine, Keppel Street, London WC1E 7HT, UK.
authors.forename: Lale
authors.initials: L
authors.lastname: Hirte
authors.forename: Ellen
authors.initials: E
authors.lastname: Nolte
authors.forename: Chris
authors.initials: C
authors.lastname: Bain
authors.forename: Martin
authors.initials: M
authors.lastname: McKee
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000401:mortality*; D015331:Cohort Studies; D005260:Female; D005298:Fertility; D006801:Humans; D008875:Middle Aged; D012426:Russia / Q000453:epidemiology; D013995:Time; D014455:Ukraine / Q000453:epidemiology