Divergent Patterns and Trends in Breast Cancer Incidence, Mortality and Survival Among Older Women in Germany and the United States

Jansen, Lina; Holleczek, Bernd; Kraywinkel, Klaus; Weberpals, Janick; Schröder, Chloé Charlotte; Eberle, Andrea; Emrich, Katharina; Kajüter, Hiltraud; Katalinic, Alexander; Kieschke, Joachim; Nennecke, Alice; Sirri, Eunice; Heil, Joerg; Schneeweiß, Andreas; Brenner, Hermann

doi:10.3390/cancers12092419

Cited by 12 publications

(3 citation statements)

References 28 publications

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“…According to the latest global cancer statistics in 2020, breast cancer incidence ranked first among all cancer types, accounting for 284,200 new cases. 1 Surgery is the most important treatment for breast cancer, but some patients will inevitably undergo complications after surgery, especially involving shoulder joint dysfunction following mastectomy and axillary lymph node dissection (ALND). 2 Therefore, it is important to promote functional exercise rehabilitation for patients with breast cancer who have undergone surgery, especially mastectomy and ALND.…”

Section: Introductionmentioning

confidence: 99%

Predictive Model of Functional Exercise Compliance of Patients with Breast Cancer Based on Decision Tree

Luo¹,

Luo²,

Wang³

et al. 2023

IJWH

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Objective Regular functional exercise can help recover the functions of upper limb for patients with breast cancer. By finding the influencing factors of functional exercise compliance and constructing a predictive model, patients with a poor functional exercise compliance can be better identified. This study aims to find out the factors influencing the functional exercise compliance of patients with breast cancer and build a predictive model based on decision tree. Methods Convenience sampling was used at two tertiary hospitals in Shantou from August 2020 to March 2021. Data of patients with breast cancer patient was obtained from questionnaires and based on demographics, Constant-Murley Score, Functional Exercise Compliance Scale for Postoperative Breast Cancer Patients, Champion Health Belief Model Scale, Social Support Rating Scale, Disease Perception Questionnaire and Family Care Index Questionnaire. Possible influencing factors of functional exercise compliance were analyzed using correlation analysis as well as univariate and binary logistic regression analysis through SPSS v25, and a CHAID decision tree was used to construct a predictive model on training, validation and test sets via SPSS Modeler v18 at a ratio of 6:2:2. Prediction accuracy, sensitivity, specificity and AUC were used to analyze the efficacy of the predictive model. Results A total of 227 valid samples were collected, of which 145 were assessed with a poor compliance (63.9%). According to a logistic regression analysis, perceived benefits, time after surgery and self-efficacy were influencing factors. The prediction accuracy, sensitivity, specificity and AUC of the predictive model, based on a CHAID decision tree analysis, were 70.73%, 57.1%, 77.8% and 0.81 respectively. Conclusion The predictive model, based on a CHAID decision tree analysis, had a moderate predictive efficacy, which could be used as a clinical auxiliary tool for clinical nurses to predict patients’ functional exercise compliance.

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Section: Introductionmentioning

confidence: 99%

Predictive Model of Functional Exercise Compliance of Patients with Breast Cancer Based on Decision Tree

Luo¹,

Luo²,

Wang³

et al. 2023

IJWH

View full text Add to dashboard Cite

show abstract

“…Particularly, in the US, the risk of developing cancer is nearly 10 times higher in persons aged 65 years than in persons under the age of 65 years, and it is estimated that 70% of all cancers will occur among adults aged ≥ 65 years by 2030 [ 4 , 5 ]. In addition, changes in reproductive patterns and the use of postmenopausal hormone therapy may also contribute to the strong increase in BC incidence [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

Changes in the incidence of early-onset breast cancer in Germany between 2010 and 2022

Gremke¹,

Wagner²,

Kalder³

et al. 2023

Breast Cancer Res Treat

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Purpose The aim of this study was to identify the mean age at which breast cancer (BC) was first diagnosed in 2010 or 2022, and to evaluate whether there were any changes in age groups at first BC diagnosis. Methods This retrospective cross-sectional study included adult women (18 years or older) who were diagnosed with BC (ICD-10: C50) for the first time in 2010 or 2022 in office-based practices in Germany (in 300 general practices or 95 gynecological practices). We examined the mean age at diagnosis and the percentage of patients in three age groups (18–49, 50–65, and > 65) for both 2010 and 2022. The average age difference between 2010 and 2022 was analyzed using Wilcoxon rank tests, and the proportions of the three age groups were analyzed using chi-squared tests. These analyses were performed separately for patients in general and gynecological practices. Results The mean age at which BC was initially diagnosed in 2022 was found to be significantly greater than that in 2010 for both general practices (66.9 years vs. 64.0 years p < 0.001) and gynecological practices (62.2 years vs. 60.3 years, p < 0.001). Early-onset BC decreased from 15.6 to 12.0% in general practices and from 23.2 to 18.2% in gynecological practices between 2010 and 2022. The proportion of new BC diagnoses in the age group 50–65 increased from 36.6 to 40.9% in gynecological practices, but did not increase in general practices. Conclusion The study found that BC was diagnosed at an older age in 2022 than in 2010. In addition, the proportion of early-onset BC cases decreased, while the proportion of cases in the age group 50–65 increased in gynecological practices in Germany.

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“…5,6 In parallel to screening efforts increasing world-wide, novel treatment options for women with advanced breast cancer stages have also been introduced over the last two decades leading to improved survival rates, particularly for advanced stages without distant metastases. 7,8 Consequently, the reduction in breast cancer mortality due to screening might be lower if trials were conducted nowadays. However, mammography techniques have also improved such that the present sensitivity of imaging techniques might have resulted in greater mortality reductions as compared to the earlier trials.…”

Section: Introduction Backgroundmentioning

confidence: 99%

Effectiveness of Mammography Screening on Breast Cancer Mortality – A Study Protocol for Emulation of Target Trials Using German Health Claims Data

Braitmaier¹,

Kollhorst²,

Heinig³

et al. 2022

CLEP

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Background The efficacy of mammography screening in reducing breast cancer mortality has been demonstrated in randomized trials. However, treatment options - and hence prognosis – for advanced tumor stages as well as mammography techniques have considerably improved since completion of these trials. Consequently, the effectiveness of mammography screening under current conditions is unclear and controversial. The German mammography screening program (MSP), an organized population-based screening program, was gradually introduced between 2005 and 2008 and achieved nation-wide coverage in 2009. Objective We describe in detail a study protocol for investigating the effectiveness of the German MSP in reducing breast cancer mortality in women aged 50 to 69 years based on health claims data. Specifically, the proposed study aims at estimating per-protocol effects of several screening strategies on cumulative breast cancer mortality. The first analysis will be conducted once 10-year follow-up data are available. Methods and Analysis We will use claims data from five statutory health insurance providers in Germany, covering approximately 37.6 million individuals. To estimate the effectiveness of the MSP, hypothetical target trials will be emulated across time, an approach that has been demonstrated to minimize design-related biases. Specifically, the primary contrast will be in terms of the cumulative breast cancer mortality comparing the screening strategies of “never screen” versus “regular screening as intended by the MSP”. Ethics and Dissemination In Germany, the utilization of data from health insurances for scientific research is regulated by the Code of Social Law. All involved health insurance providers as well as the responsible authorities approved the use of the health claims data for this study. The Ethics Committee of the University of Bremen determined that studies based on claims data are exempt from institutional review. The findings of the proposed study will be published in peer-reviewed journals.

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Divergent Patterns and Trends in Breast Cancer Incidence, Mortality and Survival Among Older Women in Germany and the United States

Cited by 12 publications

References 28 publications

Predictive Model of Functional Exercise Compliance of Patients with Breast Cancer Based on Decision Tree

Predictive Model of Functional Exercise Compliance of Patients with Breast Cancer Based on Decision Tree

Changes in the incidence of early-onset breast cancer in Germany between 2010 and 2022

Effectiveness of Mammography Screening on Breast Cancer Mortality – A Study Protocol for Emulation of Target Trials Using German Health Claims Data

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