(WHO Europe Region)
Mortality and survival
Breast cancer has the highest mortality of any cancer in women worldwide. Breast cancer claims the lives of more European women than any other cancer.2
Estimated number of women who died from breast cancer in 20182
WHO Europe region:150,700
EU-28 member states:98,735
The average 5-year relative survival of European women diagnosed with breast cancer in 1995-1999 was4
Estimated numbers and age-standardised breast cancer incidence and mortality rates* in women per 100,000 in 2018.2
|Numbers||Age-standardised rate (W)*||Numbers||Age-standardised rate (W)*|
|WHO Europe region**||562,568||--||150,700||--|
|Republic of Moldova||1646||48.2||723||19.7|
*Age-standardised rate (W): A rate is the number of new cases or deaths per 100,000 persons per year. An age-standardised rate is the rate that a population would have if it had a standard age structure. Standardization is necessary when comparing several populations that differ with respect to age because age has a powerful influence on the risk of cancer.
**WHO Europe region includes 53 countries. Incidence data include all countries except for Andorra, Monaco and San Marino.
FACTS ABOUT LIFESTYLE AND BREAST CANCER
The increasing number of breast cancer cases may be due to changes in lifestyle habits, increase in sedentary lifestyle, weight gain and obesity and sociological changes such as increasing age at first birth and decreasing number of children born to women.1
Physical activity and weight
Excess body weight and physical inactivity account for approximately 25–33% of breast cancer cases.5
There is an inverse relationship between obesity (BMI of 30 or higher) and breast cancer in pre-menopausal women and a direct relationship in post-menopausal women.1
Inactivity is estimated to cause 10-16% of all breast cancer cases.6
The effect of weight loss is independent of physical activity. 6
Having children at a younger age (under 30), having several children, and breast-feeding for long periods of time reduces breast cancer risk.1
Having first menstruation prior to 12 years old and/or menopause after age 55 increases the probability of developing breast cancer.11 For each year in delay of menarche the risk decreases by about 15% and for each year of delay of menopause it increases about 3%.1,12
Meta analyses show that breast cancer risk increases by around 7-12% per unit of alcohol per day.7,8,9 Light drinkers, up to one alcoholic drink per day (which corresponds to 12 grams or 15 ml of pure alcohol) have a 5% higher breast cancer risk compared with non drinkers.10
Menopausal therapy and use of contraceptives
There is a very clear connection between hormone replacement therapy (HRT) and the risk of developing breast cancer.13,14 In the Million Women Study, current users of HRT at recruitment were more likely than never users to develop breast cancer (adjusted relative risk 1.66).15 Breast cancer risk increases the longer HRT is taken.13,14
Based on a comprehensive amount of evidence, the IARC has concluded that long-term combined estrogen-progestogen menopausal therapy causes cancers of the breast.1
The risk depends on the length of use of HRT and is reduced once treatment is stopped, levelling off 5 or more years after stopping treatment.12
Combined estrogen-progestogen oral contraceptives are associated with an increased risk of breast cancer, notably among young women1
Women currently or recently taking oral contraceptives have a 15-25% higher risk of breast cancer compared with women who have never used oral contraceptives. This risk levels off 10 or more years after stopping oral contraceptive use.12
- Stewart BW, Wild CP, editors (2014). World Cancer Report 2014. Lyon, France: International Agency for Research on Cancer
- Ferlay J, Ervik M, Lam F, Colombet M, Mery L, Piñeros M, Znaor A, Soerjomataram I, Bray F (2018). Global Cancer Observatory: Cancer Today. Lyon, France: International Agency for Research on Cancer. Available from: http://gco.iarc.fr/today [accessed on 30 October 2018]. Statistics for Europe are based on WHO Europe region of 53 countries. Data for Andorra, Monaco and San Marino are not included.
- Curado MP, Edwards B, Shin HR, Storm H, Ferlay J, Heanue M et al. Cancer Incidence in Five Continents, Vol. IX, IARC Scientific Publications No. 160. IARCPress: Lyon: 2007.
- Berrino F, Verdecchia A, Lutz JM, Lombardo C, Micheli A, Capocaccia R; EUROCARE Working Group. et al. EUROCARE Working group. Comparative cancer survival information in Europe. Eur J Cancer 2009, 45(6): 901-8. EUROCARE 4 study (http://www.eurocare.it/DatabaseEU4/tabid/78/Default.aspx)
- The International Agency for Research on Cancer.
- The International Agency for Research on Cancer. Weight Control and Physical Activity. IARC Handbook of Cancer Prevention, Vol. 6. IARC: Lyon 2002.
- Collaborative Group on Hormonal Factors in Breast Cancer. Alcohol, tobacco and breast cancer - collaborative reanalysis of individual data from 53 epidemiological studies, including 58 515 women with breast cancer and 95 067 women without the disease. Br J Cancer 2002;87(11):1234-45.
- Allen NE, Beral V, Casabonne D, et al. Moderate Alcohol Intake and Cancer Incidence in Women. J Natl Cancer Inst 2009;101(5):296-305.
- Key J, Hodgson S, Omar R, et al. Meta- analysis of Studies of Alcohol and Breast Cancer with Consideration of the Methodological Issues. Cancer Cause Control 2006;17(6):759-70
- Bagnardi V, Rota M, Botteri E, et al. Light alcohol drinking and cancer: a meta-analysis. Ann Oncol2012;24(2):301- 8. 2008
- CDC - National Center for Health Statistics- What are risk factors for Breast Cancer. Available from: https://www.cdc.gov/cancer/breast/basic_info/risk_factors.htm [accessed on 4 June 2017]
- Boyle, P., Levin, B. (eds.). World Health Organization. International Agency for Research on Cancer. World Cancer Report 2008.
- Women’s Health Initiative Study (www.whi.org).
- Million Women Study (www.millionwomenstudy.org).
- Million Women Study Collaborators. Breast cancer and hormone replacement therapy in the Million Women Study. Lancet 2003, 362: 419-27