Trends in incidence and mortality of female breast cancer in Suriname for the period 1980–2014: Implications for the healthcare system

ABSTRACT

OBJECTIVE: The aim was to analyse current breast cancer burden in relation to demographic and socio-economic indicators. This paper presents preliminary analysis of temporal trends in incidence and mortality for 1980–2013. SUBJECTS AND METHODS: data were retrieved from the histopathology database, the mortality database and the General Bureau of Statistics. Crude five-year incidence and mortality rates were calculated and expressed per 100000 women. Data are presented with 95% confidence intervals and average annual per cent changes (AAPC) over each period. Statistical significance was tested using Chi-squared for trend. RESULTS: Breast cancer incidence increased by 48% between 1980–1984 and 2000–2004 (÷2 2.32, p = 0.0004), from 13.5 (95% CI 11.1, 15.9) to 19.9 (95% CI 17.4, 22.5). From 2005 onward, the incidence rose exponentially (÷2 48.54, p-value < 0.0000001), from 19.9 (95% 17.4, 22.5) to 48.9 (95% 45.2, 52.6). The AAPC between 1980 and 2004 was 2%, but increased to 16% between 2005 and 2014, signifying the substantial rise in incidence. The upward trend for 1980–2014 was statistically significant(÷2 399.07, p-value < 0.0000001). Breast cancer mortality increased by 80.3%, from 5.33 (95% CI 3.84, 6.82) to 10.50 (95% CI 8.56, 12.43) during the period 2000–2004, with an AAPC of 3.3% (÷2 17.71, p = 0.00003). From 2005 on, the increase was 9%, with an AAPC of 0.7% (÷2 0.40, p = 0.53). The upward trend for 1980–2013 was statistically significant (÷2 44.83, p < 0.0000001). CONCLUSION: Results show that breast cancer incidence in Suriname is increasing while mortality remains stable, suggesting improvements in diagnostic and treatment services. These results are a first step to understanding breast cancer burden and establishing an evidence-based cancer control programme.