Distinct temporal trends in breast cancer incidence from 1997 to 2016 by molecular subtypes: A population-based study of Scottish cancer registry data

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Abstract
Background: Strategies for breast cancer prevention are informed by assessing whether incidence differs by tumour biology. We describe temporal trends of breast cancer incidence by molecular subtypes in Scotland. Methods: Population-based cancer registry data on 72,217 women diagnosed with incident primary breast cancer from 1997 to 2016 were analysed. Age-standardised rates (ASR) and age-specific incidence were estimated by tumour subtype after imputing the 8% of missing oestrogen receptor (ER) status. Joinpoint regression and age- period- cohort models were used to assess whether significant differences were observed in incidence trends by ER status. Results: ER positive tumour incidence steadily increased particularly for women of screening age 50 to 69 years from 1997 till around 2011 (1.6%/year, 95%CI: 1.2 to 2.1). ER negative incidence decreased among all ages at a consistent rate of −0.7%/year (95%CI: −1.5, 0) from around 2000-2016. Compared to the 1941-1959 central birth cohort, women born 1912-1940 had lower incidence rate ratios (IRR) for ER+ tumours and women born 1960- 1986 had higher IRR for ER- tumours. Conclusions: We show evidence of aetiologic heterogeneity of breast cancer. Future incidence and survival reporting should be monitored by molecular subtypes.
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