Breast cancer deaths expected to fall in the EU and UK by 2025 across most age groups

Death rates from breast cancer will fall in 2025 in every age group in the EU and the UK apart from in EU patients aged 80 years and older. In these older patients, overall mortality rates from the disease are predicted to rise by nearly 10% in 2025.

However, in the UK, breast cancer death rates are expected to decrease by 7% in this age group, compared to rates observed between 2015-2019. In Spain, there is also a 4% decrease in patients aged 80 and over.

These findings are from a new study published in the leading cancer journal Annals of Oncology today (Wednesday), which predicts death rates from cancer in the EU and UK for 2025.

Researchers led by Carlo La Vecchia (MD), Professor of Medical Statistics and Epidemiology at the University of Milan (Italy), suspect that the reason why death rates from breast cancer are increasing in older patients in the EU is because women aged 80 and older are not screened regularly for breast cancer and are less likely to receive the most up-to-date treatments.

Prof. La Vecchia said: "Elderly women are not covered by screening and probably are less favourably affected by the substantial advances in breast cancer management, including improvements in chemo- and hormone therapy, such as trastuzumab and related drugs, but also in radiotherapy and surgery.

"The increased prevalence of overweight and obesity over the last few decades in most of northern and central Europe has led to an increased risk of breast cancer. In the elderly, this has not been counter-balanced by improved diagnosis and management. This accounts for the increased mortality in people aged 80 and over."

Younger women aged between 20 to 49 years are usually not screened regularly either, but the experts predict death rates will fall by about 7% in this age group in the EU and by almost 15% in the UK, compared to death rates seen between 2015-2019.

Prof. La Vecchia and colleagues predict that, compared to death rates in 2020, breast cancer rates overall will fall by 4% in the EU and by 6% in the UK in 2025. The age standardised mortality rate (ASMR) in the EU will be 13.3 deaths per 100,000 of the female population (a total of 90,100 deaths) and 13.2 per 100,000 in the UK (a total of 11,400 deaths).

The rates vary by country and age group. In Germany, overall breast cancer death rates will fall by 14%, in the UK by 10%, in Poland by 9%, in France and Spain by 8%, and in Italy by 2%. Across all age groups, breast cancer death rates will fall by 7%-12% in the EU in different age groups, with the exception of women aged 80 and over where there will be an increase in the EU, apart from Spain.

"We estimate that between 1989 and 2025, 373,000 breast cancer deaths have been avoided in the EU and 197,000 in the UK. Most of these are due to improved management and therapy, but 25-30% are likely to be attributable to more widespread screening and early diagnosis," said Prof. La Vecchia.

"Given that breast cancer is now a largely curable cancer that requires modern integrated approaches, it is essential that all diagnoses of breast cancer are referred to comprehensive cancer centres, which can offer the complete range of therapies that might be required.

"As indicated by the unfavorable trends in elderly women, control of overweight and obesity is a priority now, not only for cardiovascular diseases, but also for cancer, including breast cancer."

All cancers:

The researchers analyzed cancer death rates in the EU 27 Member States as a whole and separately in the UK. They looked at the five most populous EU countries (France, Germany, Italy, Poland and Spain) and, individually, for stomach, intestines, pancreas, lung, breast, uterus (including cervix), ovary, prostate, bladder and leukemias for men and women]. Prof. La Vecchia and his colleagues collected data on deaths from the World Health Organization and United Nations databases from 1970 to 2021 for most of the EU-27 and the UK. This is the fifteenth consecutive year the researchers have published these predictions, which have proved to be reliable over the years.

In the EU-27 countries, they predict there will be a 3.5% fall in the age-standardized death rates for all cancers from 125 per 100,000 of the population in 2020 to 121 per 100,000 in 2025 for men, and a 1% fall from 80 to 79 per 100,000 among women. A total of approximately 1,280,000 people will die from the disease in the EU and 173,000 in the UK.

In the UK, the age-standardized death rate for all cancers in men will fall by 10% from 112 to 101 per 100,000, and by 6% from 87.6 to 82 per 100,000 among women in 2025.

However, due to the increasing numbers of elderly people in the population, the actual number of deaths from cancer will rise from 671,963 in 2020 to 709,400 men in the EU in 2025, and from 537,866 to 570,500 women. In the UK, the number of deaths will rise from 91,239 to 92,200 men and from 80,378 to 81,100 women.

Death rates from most cancers are predicted to fall this year in the EU, with the exception of pancreatic cancer: up 2% in men and 3% in women. In women, lung cancer is also predicted to rise by nearly 4%, and bladder cancer will rise by nearly 2%.

In the UK, the only death rates predicted to rise are those for bowel cancer in women and in the uterus (both by less than 1%). Death rates from all other cancers are falling in both sexes.

Smoking remains by far the major recognised cause of pancreatic cancer, accounting for 20 to 35% of cases in various populations and age groups, according to their different smoking habits. Diabetes, being overweight and developing the metabolic syndrome account for around 5% of pancreatic cancers in Europe. This is becoming more and more important following the increasing prevalence of obesity, but control and avoidance of smoking remains the top priority for pancreatic cancer control."

Prof. Eva Negri from the University of Bologna (Italy), co-leader of the research

Over 37 years between 1988 and 2025, the researchers calculated the number of cancer deaths avoided, assuming that rates remained constant at the 1988 rates. They estimate that a total of 6.8 million deaths from all cancers have been avoided in the EU (4,700,000 in men and 2,100,000 in women), and a total of 1,500,000 in the UK (1 million in men and 500,000 in women).

Lung cancer will kill the greatest absolute number of men in both the EU and the UK (151,000 and 16,700 respectively), and among women in the UK (15,500). In the EU, breast cancer will kill the greatest number of EU women, but the predicted death rate from lung cancer is now slightly higher than breast cancer in these women and is increasing (up 3.8%), whereas it is falling for breast cancer (down 3.6%).

Prof. La Vecchia concluded: "Trends in cancer mortality continue to be favourable across Europe. However, there are a few negative indications. These include deaths from bowel cancer in people younger than 50, which have started to increase in the UK and several central and northern Europe countries, mainly due to increased prevalence of overweight and obesity in the young who are not covered by colorectal cancer screening.

"In addition, death rates from pancreatic cancer are not decreasing in the EU, and it is now the fourth cause of cancer death in Europe after lung, colorectal and breast cancer. Death rates from lung cancer are starting to level off but not yet to decrease in EU women. The trends in pancreatic and female lung cancer underline the urgency of implementing stricter tobacco control across Europe."