title: International Variation in Female Breast Cancer Incidence and Mortality Rates.
abstract: BACKGROUND
  Breast cancer is the most frequently diagnosed cancer and the leading cause of cancer-related death among women worldwide. Herein, we examine global trends in female breast cancer rates using the most up-to-date data available.
  
  
  METHODS
  Breast cancer incidence and mortality estimates were obtained from GLOBOCAN 2012 (globocan.iarc.fr). We analyzed trends from 1993 onward using incidence data from 39 countries from the International Agency for Research on Cancer and mortality data from 57 countries from the World Health Organization.
  
  
  RESULTS
  Of 32 countries with incidence and mortality data, rates in the recent period diverged-with incidence increasing and mortality decreasing-in nine countries mainly in Northern/Western Europe. Both incidence and mortality decreased in France, Israel, Italy, Norway, and Spain. In contrast, incidence and death rates both increased in Colombia, Ecuador, and Japan. Death rates also increased in Brazil, Egypt, Guatemala, Kuwait, Mauritius, Mexico, and Moldova.
  
  
  CONCLUSIONS
  Breast cancer mortality rates are decreasing in most high-income countries, despite increasing or stable incidence rates. In contrast and of concern are the increasing incidence and mortality rates in a number of countries, particularly those undergoing rapid changes in human development. Wide variations in breast cancer rates and trends reflect differences in patterns of risk factors and access to and availability of early detection and timely treatment.
  
  
  CONCLUSIONS
  Increased awareness about breast cancer and the benefits of early detection and improved access to treatment must be prioritized to successfully implement breast cancer control programs, particularly in transitioning countries.
authors.affiliation: American Cancer Society Intramural Research, Atlanta, Georgia. Carol.DeSantis@cancer.org.
authors.forename: Carol E
authors.initials: CE
authors.lastname: DeSantis
authors.affiliation: Section of Cancer Surveillance, International Agency for Research on Cancer, Lyon, France.
authors.forename: Freddie
authors.initials: F
authors.lastname: Bray
authors.affiliation: Section of Cancer Surveillance, International Agency for Research on Cancer, Lyon, France.
authors.forename: Jacques
authors.initials: J
authors.lastname: Ferlay
authors.affiliation: American Cancer Society Intramural Research, Atlanta, Georgia.
authors.forename: Joannie
authors.initials: J
authors.lastname: Lortet-Tieulent
authors.affiliation: Breast Health Global Initiative, Fred Hutchinson Cancer Research Center, and University of Washington, Seattle, Washington.
authors.forename: Benjamin O
authors.initials: BO
authors.lastname: Anderson
authors.affiliation: American Cancer Society Intramural Research, Atlanta, Georgia.
authors.forename: Ahmedin
authors.initials: A
authors.lastname: Jemal
mesh_terms: D001943:Breast Neoplasms / Q000453:epidemiology*; D005260:Female; D014943:Global Health; D006801:Humans; D015994:Incidence; D007390:International Agencies / Q000706:statistics & numerical data*; D015995:Prevalence; D012042:Registries; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate / Q000639:trends