title: A population-based study of breast cancer prevalence in Australia: predicting the future health care needs of women living with breast cancer.
abstract: BACKGROUND
  Breast cancer places a heavy burden on the Australian healthcare system, but information about the actual number of women living with breast cancer and their current or future health service needs is limited. We used existing population-based data and innovative statistical methods to address this critical research question in a well-defined geographic region.
  
  
  METHODS
  Breast cancer data from the New South Wales (NSW) Central Cancer Registry and PIAMOD (Prevalence and Incidence Analysis MODel) software were used to project future breast cancer prevalence in NSW. Parametric models were fitted to incidence and survival data, and the modelled incidence and survival estimates were then used to estimate current and future prevalence. To estimate future healthcare requirements the projected prevalence was then divided into phases of care according to the different stages of the survivorship trajectory.
  
  
  RESULTS
  The number of women in NSW living with a breast cancer diagnosis had increased from 19,305 in 1990 to 48,754 in 2007. This number is projected to increase further to 68,620 by 2017. The majority of these breast cancer survivors will require continued monitoring (31,974) or will be long-term survivors (29,785). About 9% will require active treatment (either initial therapy, or treatment for subsequent metastases or second cancer) and 1% will need end of life care due to breast cancer.
  
  
  CONCLUSIONS
  Extrapolating these projections to the national Australian population would equate to 209,200 women living with breast cancer in Australia in 2017, many of whom will require active treatment or post-treatment monitoring. Thus, careful planning and development of a healthcare system able to respond to this increased demand is required.
authors.affiliation: Cancer Research Division, Cancer Council New South Wales, Sydney, Australia. xueqiny@nswcc.org.au.
authors.forename: Xue Qin
authors.initials: XQ
authors.lastname: Yu
authors.forename: Roberta
authors.initials: R
authors.lastname: De Angelis
authors.forename: Qingwei
authors.initials: Q
authors.lastname: Luo
authors.forename: Clare
authors.initials: C
authors.lastname: Kahn
authors.forename: Nehmat
authors.initials: N
authors.lastname: Houssami
authors.forename: Dianne L
authors.initials: DL
authors.lastname: O'Connell
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001315:Australia / Q000453:epidemiology; D001943:Breast Neoplasms / Q000453:epidemiology* / Q000266:history / Q000401:mortality; D005260:Female; D006301:Health Services Needs and Demand; D049673:History, 20th Century; D049674:History, 21st Century; D006801:Humans; D015994:Incidence; D008875:Middle Aged; D015233:Models, Statistical; D009362:Neoplasm Metastasis; D016609:Neoplasms, Second Primary / Q000453:epidemiology; D011159:Population Surveillance; D015995:Prevalence; D012042:Registries; D015203:Reproducibility of Results; D017741:Survivors; D055815:Young Adult