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Abstract
Introduction. Breast cancer (BC) is a leading cause of cancer-related mortality among women globally and in the Russian Federation (RF). Prognosis is largely determined by stage at diagnosis.
Aim. To assess trends in incidence, mortality, and five-year relative survival of BC by stage at diagnosis and age group across the constituent regions of the North-West Federal District (NWFD) of the Russian Federation over the period 2008–2023.
Materials and Methods. The analysis included data on 87,498 incident cases of invasive BC (ICD-10 C50.0–C50.9). We assessed age-standardized incidence rates (ASIR, Segi 1960 world standard) and age-standardized mortality rates (ASMR), as well as five-year relative survival estimated using the Ederer II method with 95 % confidence intervals.
Results. The ASIR of BC in the NWFD increased from 48.4 in 2008–2012 to 59.4 in 2018–2022 (+22.7 %), driven predominantly by an increase in early-stage disease. The proportion of stage I cases rose from 19.8 % to 31.0 %, and the stage I ASIR more than doubled from 9.97 to 18.40 (+84.6 %). Concurrently, the ASMR declined from 18.2 to 14.2 per 100,000 female population in 2018–2022 (−21.7 %). Five-year relative survival improved from 71.0 % to 79.1 %, with the most notable gains observed for stage III (50.4 % → 60.0 %) and stage IV disease (17.0 % → 22.9 %). For stage IV, however, the stage-specific ASMR increased from 3.01 to 4.72 (+56.8 %), and the M:I ratio rose from 1.01 to 1.16. In 2018–2022, considerable heterogeneity was observed across NWFD regions: stage-specific ASIR ranged from 50.9 to 62.0 per 100,000, the proportion of stage I disease varied from 20.0 % to 38.5 %, and five-year relative survival ranged from 74.7 % to 85.5 %.
Conclusion. Over the period 2008–2023, BC incidence in the NWFD increased primarily due to early-stage detection, accompanied by declining mortality and improving survival, particularly at advanced stages. The marked interregional heterogeneity suggests a need for enhanced access to modern diagnostic tools and systemic therapy for BC.
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