Breast cancer incidence, by stage at diagnosis, and mortality in 21 European countries in the era of mammography screening: an international population-based study

Rafael Cardoso; Idris Ola; Lina Jansen; Monika Hackl; Petra Ihle; Julie Francart; Nancy Van Damme; Zdravka Valerianova; Trayan Atanasov; Ondřej Májek; Ondřej Ngo; Kaire Innos; Margit Mägi; Sandrine Dabakuyo Yonli; Anne-Sophie Woronoff; Brigitte Tretarre; Florence Poncet; Alexander Katalinic; Paul M. Walsh; Ieva Vincerževskienė; Laura Steponaviciene; Linda de Munck; Sabine Siesling; Tom Børge Johannesen; Solveig Hofvind; Rita Calisto; Maria José Bento; Filipa Alves da Costa; Alexandra Mayer; António Lourenço; Tina Žagar; Sonja Tomšič; Miguel Rodríguez-Barranco; Maria-José Sánchez; Arantza Lopez de Munain Marques; Rafael Marcos-Gragera; Arantza Sanvisens; Antonia Sánchez Gil; María-Dolores Chirlaque Lopez; Jaume Galceran; Francina Saladié; Kristina Sundquist; Jan Sundquist; Mats-Åke Persson; Marcel Blum; Mohsen Mousavi; Roger von Moos; Olena Sumkina; Anton Ryzhov; Michael Hoffmeister; Hermann Brenner

Breast cancer incidence, by stage at diagnosis, and mortality in 21 European countries in the era of mammography screening: an international population-based study

Rafael Cardoso, Idris Ola, Lina Jansen, Monika Hackl, Petra Ihle, Julie Francart, Nancy Van Damme, Zdravka Valerianova, Trayan Atanasov, Ondřej Májek, Ondřej Ngo, Kaire Innos, Margit Mägi, Sandrine Dabakuyo Yonli, Anne-Sophie Woronoff, Brigitte Tretarre, Florence Poncet, Alexander Katalinic, Paul M. Walsh, Ieva VincerževskienėLaura Steponaviciene, Linda de Munck, Sabine Siesling, Tom Børge Johannesen, Solveig Hofvind, Rita Calisto, Maria José Bento, Filipa Alves da Costa, Alexandra Mayer, António Lourenço, Tina Žagar, Sonja Tomšič, Miguel Rodríguez-Barranco, Maria-José Sánchez, Arantza Lopez de Munain Marques, Rafael Marcos-Gragera, Arantza Sanvisens, Antonia Sánchez Gil, María-Dolores Chirlaque Lopez, Jaume Galceran, Francina Saladié, Kristina Sundquist, Jan Sundquist, Mats-Åke Persson, Marcel Blum, Mohsen Mousavi, Roger von Moos, Olena Sumkina, Anton Ryzhov, Michael Hoffmeister, Hermann Brenner

3 Zitate (Scopus)

Abstract

BackgroundMammography screening programmes have been widely implemented across European countries over the past 40 years with the main aim to detect breast cancer earlier and thereby reduce breast cancer mortality. This study aimed to analyse and compare changes over time in breast cancer incidence, by stage at diagnosis, and breast cancer mortality across countries in relation to the timing of screening implementation and age at diagnosis.

Originalsprache	Englisch
Aufsatznummer	101574
Zeitschrift	The Lancet regional health. Europe
Jahrgang	62
ISSN	2666-7762
Publikationsstatus	Veröffentlicht - 03.2026

Fördermittel

We are thankful to all cancer registries and their staff for the efforts in collecting and preparing the data for this study—specifically, the Austrian National Cancer Registry; Belgian Cancer Registry; Bulgarian National Cancer Registry; Czech National Cancer Registry, Institute of Health Information and Statistics of the Czech Republic; National Cancer Registration and Analysis Service, National Disease Registration, Public Health England (data provided under the Open Government Licence), Estonian Cancer Registry, Registry of Breast Cancers and other Gynaecological Cancers of Cote d'Or, Cancer Registry of Doubs, Herault Tumour Registry, Cancer Registry of Isere, German Centre for Cancer Registry Data, National Cancer Registry Ireland, Lithuanian Cancer Registry, Netherlands Cancer Registry, Cancer Registry of Norway, North Region Cancer Registry of Portugal, South Region Cancer Registry of Portugal, Slovenian Cancer Registry, Granada Cancer Registry, Girona Cancer Registry, Murcia Cancer Registry, Tarragona Cancer Registry, Swedish Cancer Registry, Cancer Registry of Eastern Switzerland, Cancer Registry of Liechtenstein, Cancer Registry of Grisons-Glarus, and National Cancer Registry of Ukraine. We are also grateful to the US National Cancer Institute for providing the Joinpoint regression software for our analyses. The work of O.M. and O.N. at Masaryk University is supported by the NPO “Systemic Risk Institute” number LX22NPO5101, funded by European Union–Next Generation EU (Ministry of Education, Youth and Sports, NPO: EXCELES). The work of K.I. was supported by Estonian Research Council (grant no PRG722 and PRG2543). The work of O.M. and O.N. at Masaryk University is supported by the NPO “Systemic Risk Institute” number LX22NPO5101, funded by European Union –Next Generation EU (Ministry of Education, Youth and Sports, NPO: EXCELES). The work of K.I. was supported by Estonian Research Council (grant no PRG722 and PRG2543 ).

Träger	Trägernummer
Institute of Health Information and Statistics
Netherlands Cancer Registry
National Cancer Registry of Ukraine
Slovenian Cancer Registry
European Commission
National Cancer Registry Ireland
National Cancer Institute
Granada Cancer Registry
Registry of Breast Cancers
Eesti Teadusagentuur
Ministry of Education, Youth and Sports
Czech National Cancer Registry
Bulgarian National Cancer Registry
Cancer Registry of Norway
Estonian Cancer Registry
Lithuanian Cancer Registry
Masarykova Univerzita	LX22NPO5101
Estonian Research Council	PRG2543, PRG722

UN SDGs

Dieser Output leistet einen Beitrag zu folgendem(n) Ziel(en) für nachhaltige Entwicklung

SDG 3 – Gesundheit und Wohlergehen

Strategische Forschungsbereiche und Zentren

Profilbereich: Zentrum für Bevölkerungsmedizin und Versorgungsforschung (ZBV)

DFG-Fachsystematik

2.22-02 Public Health, gesundheitsbezogene Versorgungsforschung, Sozial- und Arbeitsmedizin
2.22-14 Hämatologie, Onkologie
2.22-21 Gynäkologie und Geburtshilfe

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Cardoso, R., Ola, I., Jansen, L., Hackl, M., Ihle, P., Francart, J., Van Damme, N., Valerianova, Z., Atanasov, T., Májek, O., Ngo, O., Innos, K., Mägi, M., Yonli, S. D., Woronoff, A.-S., Tretarre, B., Poncet, F., Katalinic, A., Walsh, P. M., ... Brenner, H. (2026). Breast cancer incidence, by stage at diagnosis, and mortality in 21 European countries in the era of mammography screening: an international population-based study. The Lancet regional health. Europe, 62, Artikel 101574.

@article{0f85bcc68e9c4716a4510188701a11f6,

title = "Breast cancer incidence, by stage at diagnosis, and mortality in 21 European countries in the era of mammography screening: an international population-based study",

abstract = "Background: Mammography screening programmes have been widely implemented across European countries over the past 40 years with the main aim to detect breast cancer earlier and thereby reduce breast cancer mortality. This study aimed to analyse and compare changes over time in breast cancer incidence, by stage at diagnosis, and breast cancer mortality across countries in relation to the timing of screening implementation and age at diagnosis. Methods: In this population-based study conducted in 21 European countries, data from cancer registries covering over 3 million female patients diagnosed with breast cancer, along with data from national statistical offices from 1978 to 2019 were analysed. Annual age-standardised breast cancer incidence rates (by stage and age at diagnosis) and age-standardised breast cancer mortality rates were calculated. Average annual percent changes (AAPCs) in these metrics within 10 years before and 10 years after screening implementation were estimated. Findings: Overall, breast cancer incidence rates increased over the study period, with the largest increases observed in the first two decades (1978–1987 and 1988–1997), and AAPCs of up to 4.55 (95\% confidence interval, CI, 2.56–6.57). In contrast, breast cancer mortality rates decreased most predominantly in the last two decades (1998–2007 and 2008–2018/19), with AAPCs down to −5.40 (95\% CI, −9.70 to −0.89). The largest increases in incidence were seen for in situ and stage I cancers (AAPCs ranging from non-significant to 12.03 (95\% CI, 7.40–16.86) following screening implementation). Incidence of stage IV cancer declined or remained stable in most countries, with AAPCs down to −6.16 (95\% CI, −8.28 to −4.00) after screening introduction. These trends were particularly pronounced among age groups targeted by screening (mostly 50–69 years). Breast cancer mortality rates declined by up to 3 percent annually after screening initiation (lowest AAPC estimate −3.29 (95\% CI, −6.26 to −0.23); yet, AAPCs as low as −2.54 (95\% CI, −3.15 to −1.93) were also observed before introduction of screening programmes in countries where implementation occurred later, in the 2000s. Interpretation: This study suggests that mammography screening has influenced trends in breast cancer incidence and mortality in European countries. The results point to the contribution of mammography screening, alongside advances in diagnostics and treatment, to the observed reductions in breast cancer mortality. Funding: There was no funding source for this study.",

author = "Rafael Cardoso and Idris Ola and Lina Jansen and Monika Hackl and Petra Ihle and Julie Francart and \{Van Damme\}, Nancy and Zdravka Valerianova and Trayan Atanasov and Ond{\v r}ej M{\'a}jek and Ond{\v r}ej Ngo and Kaire Innos and Margit M{\"a}gi and Yonli, \{Sandrine Dabakuyo\} and Anne-Sophie Woronoff and Brigitte Tretarre and Florence Poncet and Alexander Katalinic and Walsh, \{Paul M.\} and Ieva Vincer{\v z}evskienė and Laura Steponaviciene and \{de Munck\}, Linda and Sabine Siesling and Johannesen, \{Tom B{\o}rge\} and Solveig Hofvind and Rita Calisto and Bento, \{Maria Jos{\'e}\} and \{Alves da Costa\}, Filipa and Alexandra Mayer and Ant{\'o}nio Louren{\c c}o and Tina {\v Z}agar and Sonja Tom{\v s}i{\v c} and Miguel Rodr{\'i}guez-Barranco and Maria-Jos{\'e} S{\'a}nchez and \{Lopez de Munain Marques\}, Arantza and Rafael Marcos-Gragera and Arantza Sanvisens and Gil, \{Antonia S{\'a}nchez\} and \{Chirlaque Lopez\}, Mar{\'i}a-Dolores and Jaume Galceran and Francina Saladi{\'e} and Kristina Sundquist and Jan Sundquist and Mats-{\AA}ke Persson and Marcel Blum and Mohsen Mousavi and \{von Moos\}, Roger and Olena Sumkina and Anton Ryzhov and Michael Hoffmeister and Hermann Brenner",

note = "Publisher Copyright: {\textcopyright} 2025 The Authors",

year = "2026",

month = mar,

language = "English",

volume = "62",

journal = "The Lancet regional health. Europe",

issn = "2666-7762",

publisher = "Elsevier Ltd",

}

Cardoso, R, Ola, I, Jansen, L, Hackl, M, Ihle, P, Francart, J, Van Damme, N, Valerianova, Z, Atanasov, T, Májek, O, Ngo, O, Innos, K, Mägi, M, Yonli, SD, Woronoff, A-S, Tretarre, B, Poncet, F, Katalinic, A, Walsh, PM, Vincerževskienė, I, Steponaviciene, L, de Munck, L, Siesling, S, Johannesen, TB, Hofvind, S, Calisto, R, Bento, MJ, Alves da Costa, F, Mayer, A, Lourenço, A, Žagar, T, Tomšič, S, Rodríguez-Barranco, M, Sánchez, M-J, Lopez de Munain Marques, A, Marcos-Gragera, R, Sanvisens, A, Gil, AS, Chirlaque Lopez, M-D, Galceran, J, Saladié, F, Sundquist, K, Sundquist, J, Persson, M-Å, Blum, M, Mousavi, M, von Moos, R, Sumkina, O, Ryzhov, A, Hoffmeister, M & Brenner, H 2026, 'Breast cancer incidence, by stage at diagnosis, and mortality in 21 European countries in the era of mammography screening: an international population-based study', The Lancet regional health. Europe, Jg. 62, 101574.

Breast cancer incidence, by stage at diagnosis, and mortality in 21 European countries in the era of mammography screening: an international population-based study. / Cardoso, Rafael; Ola, Idris; Jansen, Lina et al.
in: The Lancet regional health. Europe, Jahrgang 62, 101574, 03.2026.

Publikation: Beiträge in Fachzeitschriften › Zeitschriftenaufsätze › Forschung › Begutachtung

TY - JOUR

T1 - Breast cancer incidence, by stage at diagnosis, and mortality in 21 European countries in the era of mammography screening: an international population-based study

AU - Cardoso, Rafael

AU - Ola, Idris

AU - Jansen, Lina

AU - Hackl, Monika

AU - Ihle, Petra

AU - Francart, Julie

AU - Van Damme, Nancy

AU - Valerianova, Zdravka

AU - Atanasov, Trayan

AU - Májek, Ondřej

AU - Ngo, Ondřej

AU - Innos, Kaire

AU - Mägi, Margit

AU - Yonli, Sandrine Dabakuyo

AU - Woronoff, Anne-Sophie

AU - Tretarre, Brigitte

AU - Poncet, Florence

AU - Katalinic, Alexander

AU - Walsh, Paul M.

AU - Vincerževskienė, Ieva

AU - Steponaviciene, Laura

AU - de Munck, Linda

AU - Siesling, Sabine

AU - Johannesen, Tom Børge

AU - Hofvind, Solveig

AU - Calisto, Rita

AU - Bento, Maria José

AU - Alves da Costa, Filipa

AU - Mayer, Alexandra

AU - Lourenço, António

AU - Žagar, Tina

AU - Tomšič, Sonja

AU - Rodríguez-Barranco, Miguel

AU - Sánchez, Maria-José

AU - Lopez de Munain Marques, Arantza

AU - Marcos-Gragera, Rafael

AU - Sanvisens, Arantza

AU - Gil, Antonia Sánchez

AU - Chirlaque Lopez, María-Dolores

AU - Galceran, Jaume

AU - Saladié, Francina

AU - Sundquist, Kristina

AU - Sundquist, Jan

AU - Persson, Mats-Åke

AU - Blum, Marcel

AU - Mousavi, Mohsen

AU - von Moos, Roger

AU - Sumkina, Olena

AU - Ryzhov, Anton

AU - Hoffmeister, Michael

AU - Brenner, Hermann

PY - 2026/3

Y1 - 2026/3

N2 - Background: Mammography screening programmes have been widely implemented across European countries over the past 40 years with the main aim to detect breast cancer earlier and thereby reduce breast cancer mortality. This study aimed to analyse and compare changes over time in breast cancer incidence, by stage at diagnosis, and breast cancer mortality across countries in relation to the timing of screening implementation and age at diagnosis. Methods: In this population-based study conducted in 21 European countries, data from cancer registries covering over 3 million female patients diagnosed with breast cancer, along with data from national statistical offices from 1978 to 2019 were analysed. Annual age-standardised breast cancer incidence rates (by stage and age at diagnosis) and age-standardised breast cancer mortality rates were calculated. Average annual percent changes (AAPCs) in these metrics within 10 years before and 10 years after screening implementation were estimated. Findings: Overall, breast cancer incidence rates increased over the study period, with the largest increases observed in the first two decades (1978–1987 and 1988–1997), and AAPCs of up to 4.55 (95% confidence interval, CI, 2.56–6.57). In contrast, breast cancer mortality rates decreased most predominantly in the last two decades (1998–2007 and 2008–2018/19), with AAPCs down to −5.40 (95% CI, −9.70 to −0.89). The largest increases in incidence were seen for in situ and stage I cancers (AAPCs ranging from non-significant to 12.03 (95% CI, 7.40–16.86) following screening implementation). Incidence of stage IV cancer declined or remained stable in most countries, with AAPCs down to −6.16 (95% CI, −8.28 to −4.00) after screening introduction. These trends were particularly pronounced among age groups targeted by screening (mostly 50–69 years). Breast cancer mortality rates declined by up to 3 percent annually after screening initiation (lowest AAPC estimate −3.29 (95% CI, −6.26 to −0.23); yet, AAPCs as low as −2.54 (95% CI, −3.15 to −1.93) were also observed before introduction of screening programmes in countries where implementation occurred later, in the 2000s. Interpretation: This study suggests that mammography screening has influenced trends in breast cancer incidence and mortality in European countries. The results point to the contribution of mammography screening, alongside advances in diagnostics and treatment, to the observed reductions in breast cancer mortality. Funding: There was no funding source for this study.

AB - Background: Mammography screening programmes have been widely implemented across European countries over the past 40 years with the main aim to detect breast cancer earlier and thereby reduce breast cancer mortality. This study aimed to analyse and compare changes over time in breast cancer incidence, by stage at diagnosis, and breast cancer mortality across countries in relation to the timing of screening implementation and age at diagnosis. Methods: In this population-based study conducted in 21 European countries, data from cancer registries covering over 3 million female patients diagnosed with breast cancer, along with data from national statistical offices from 1978 to 2019 were analysed. Annual age-standardised breast cancer incidence rates (by stage and age at diagnosis) and age-standardised breast cancer mortality rates were calculated. Average annual percent changes (AAPCs) in these metrics within 10 years before and 10 years after screening implementation were estimated. Findings: Overall, breast cancer incidence rates increased over the study period, with the largest increases observed in the first two decades (1978–1987 and 1988–1997), and AAPCs of up to 4.55 (95% confidence interval, CI, 2.56–6.57). In contrast, breast cancer mortality rates decreased most predominantly in the last two decades (1998–2007 and 2008–2018/19), with AAPCs down to −5.40 (95% CI, −9.70 to −0.89). The largest increases in incidence were seen for in situ and stage I cancers (AAPCs ranging from non-significant to 12.03 (95% CI, 7.40–16.86) following screening implementation). Incidence of stage IV cancer declined or remained stable in most countries, with AAPCs down to −6.16 (95% CI, −8.28 to −4.00) after screening introduction. These trends were particularly pronounced among age groups targeted by screening (mostly 50–69 years). Breast cancer mortality rates declined by up to 3 percent annually after screening initiation (lowest AAPC estimate −3.29 (95% CI, −6.26 to −0.23); yet, AAPCs as low as −2.54 (95% CI, −3.15 to −1.93) were also observed before introduction of screening programmes in countries where implementation occurred later, in the 2000s. Interpretation: This study suggests that mammography screening has influenced trends in breast cancer incidence and mortality in European countries. The results point to the contribution of mammography screening, alongside advances in diagnostics and treatment, to the observed reductions in breast cancer mortality. Funding: There was no funding source for this study.

UR - https://www.scopus.com/pages/publications/105025809591

UR - https://www.mendeley.com/catalogue/932f2c02-ad3a-3900-bfd3-cddad85293b8/

M3 - Journal articles

SN - 2666-7762

VL - 62

JO - The Lancet regional health. Europe

JF - The Lancet regional health. Europe

M1 - 101574

ER -

Breast cancer incidence, by stage at diagnosis, and mortality in 21 European countries in the era of mammography screening: an international population-based study

Abstract

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UN SDGs

Strategische Forschungsbereiche und Zentren

DFG-Fachsystematik

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