International Journal of Epidemiology 2000;29:969-974
© International Epidemiological Association 2000
Breast cancer incidence rates in Slovenia 1971–1993
a Division of Epidemiology and Biostatistics, European Institute of Oncology, Milan, Italy.
b Epidemiology Unit, Institute of Oncology, Ljubljana, Slovenia.
c Cancer Registry of Slovenia, Ljubljana, Slovenia.
Reprint requests: Dr C Robertson, Division of Epidemiology and Biostatistics, European Institute of Oncology, Via Ripamonti 435, 20141 Milan, Italy. E-mail: chris.robertson{at}ieo.it
Background Analyses of time trends in breast cancer incidence and mortality have generally revealed cohort-based changes in the rates. These have been linked to cohort-based changes in lifestyle factors. The effect of the changes in the reproductive risk factors on the changes in the rates, and the relative importance of the reproductive characteristics in Slovenia, a country which has not had much breast cancer screening, are investigated.
Methods Data on breast cancer incidence for 1971–1993 were obtained from the Cancer Registry of Slovenia (Registry). The Registry covers the whole population of the Republic of Slovenia (1.99 million on 30 June 1993). The statistical analysis uses parametric age-period-cohort models.
Results Breast cancer incidence has increased by 70% in Slovenia from 1971 to 1993, These changes are dominated by cohort effects and the cohorts born in 1907–1922 have the greatest increase in incidence. Period effects on changes in incidence were modest. The percentage of nulliparous women in the cohort and the average family size in the cohort explained 38% of the variation in the cohort effects.
Conclusions The percentage of nulliparous women in the cohort is the most important reproductive variable associated with the trends in the rates, with breast cancer risk predicted to be higher in cohorts with a larger percentage of nulliparous women. As the cohorts born 1932–1946 have a more favourable reproductive pattern as regards breast cancer risk, compared to the 1907–1922 cohorts, age-specific incidence rates in Slovenia would be predicted to decline in the future in the absence of changes in the other risk factors.
Keywords Breast cancer, age period cohort models, reproductive factors, time trends
Accepted 8 May 2000
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