Escalating burden of breast cancer in southern Thailand: analysis of 1990-2010 incidence and prediction of future trends.
BACKGROUND
Thailand is undergoing an epidemiologic transition, with decreasing incidence of infectious diseases and increasing rates of chronic conditions, including cancer. Breast cancer has the highest incidence rates among females both in the southern region Thailand and throughout Thailand. However, there is a lack of research on the epidemiology of this and other cancers.


METHODS
Here we use cancer incidence data from the Songkhla Cancer Registry to characterize and analyze the incidence of breast cancer in Southern Thailand. We use joinpoint analysis, age-period-cohort models and nordpred analysis to investigate the incidence of breast cancer in Southern Thailand from 1990 to 2010 and project future trends from 2010 to 2029.


RESULTS
We found that age-adjusted breast cancer incidence rates in Southern Thailand increased by almost 300% from 1990 to 2010 going from 10.0 to 27.8 cases per 100,000 person-years. Both period and cohort effects played a role in shaping the increase in incidence. Three distinct incidence projection methods consistently suggested that incidence rates will continue to increase in the future with incidence for women age 50 and above increasing at a higher rate than for women below 50.


CONCLUSIONS
To date, this is the first study to examine Thai breast cancer incidence from a regional registry. This study provides a basis for future planning strategies in breast cancer prevention and to guide hypotheses for population-based epidemiologic research in Thailand.
Department of Environmental Health Sciences, University of Michigan, Ann Arbor, MI, USA.
Shama
S
Virani
Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand.
Hutcha
H
Sriplung
Department of Environmental Health Sciences, University of Michigan, Ann Arbor, MI, USA; Department of Otolaryngology, University of Michigan, Ann Arbor, MI, USA. Electronic address: rozekl@umich.edu.
Laura S
LS
Rozek
Department of Epidemiology, University of Michigan, Ann Arbor, MI, USA.
Rafael
R
Meza
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000453:epidemiology* / Q000473:pathology; D005260:Female; D005544:Forecasting; D006801:Humans; D015994:Incidence; D008875:Middle Aged; D009017:Morbidity / Q000639:trends; D012042:Registries; D013785:Thailand; D047368:Tumor Burden
Age-period-cohort; Breast cancer; Incidence rates; Projections; Thailand; Trends