title: The effect of country wealth on incidence of breast cancer.
abstract: The aim of this study is to analyze the relationship between the incidence of breast cancer and income per capita across countries. Data on breast cancer incidence in 52 countries were obtained from GLOBOCAN, along with economic indicators of gross domestic product per capita from the World Bank. Number of computed tomography scanners and magnetic resonance imaging (from World Health Organization) were used as a surrogate for technology and access to screening for cancer diagnosis. Statistical analyses for correlation and regression were performed, along with an analysis of variance (ANOVA). A strong positive association between breast cancer incidence and gross domestic product per capita, Pearson's r = 65.4 %, controlling latitude, density of computed tomography scanners and magnetic resonance imaging was found in countries of temperate zones. The estimated relationship suggests that 1 % higher gross domestic product per capita, within the temperate zones (latitudes), increases the expected age-standardized breast cancer incidence by about 35.6 % (p < 0.001). ANOVA confirms these vital results. While some have argued that latitude and seasonality may affect breast cancer incidence, these findings suggest that wealthier nations may have a higher incidence of breast cancer independent of geographic location and screening technology.
authors.affiliation: National Research Council of Italy, CERIS-CNR, Via Real Collegio n. 30, 10024, Moncalieri, Turin, Italy, m.coccia@ceris.cnr.it.
authors.forename: Mario
authors.initials: M
authors.lastname: Coccia
mesh_terms: D001943:Breast Neoplasms / Q000453:epidemiology*; D005260:Female; D014943:Global Health / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D012959:Socioeconomic Factors