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dc.contributor.authorPollan-Santamaria, Marina 
dc.contributor.authorPastor-Barriuso, Roberto 
dc.contributor.authorArdanaz, Eva
dc.contributor.authorArgüelles, Marcial
dc.contributor.authorMartos, Carmen
dc.contributor.authorGalcerán, Jaume
dc.contributor.authorSánchez-Pérez, María-José
dc.contributor.authorChirlaque, María-Dolores
dc.contributor.authorLarrañaga, Nerea
dc.contributor.authorMartínez-Cobo, Ruth
dc.contributor.authorTobalina, María-Cres
dc.contributor.authorVidal, Enric 
dc.contributor.authorMarcos-Gragera, Rafael
dc.contributor.authorMateos, Antonio
dc.contributor.authorGarau, Isabel
dc.contributor.authorRojas-Martín, María-Dolores
dc.contributor.authorJiménez, Rosario
dc.contributor.authorTorrella-Ramos, Ana
dc.contributor.authorPerucha, Josefina
dc.contributor.authorPérez-de-Rada, Maria-Eugenia
dc.contributor.authorGonzález, Susana
dc.contributor.authorRabanaque, María-José
dc.contributor.authorBorràs, Joan
dc.contributor.authorNavarro, Carmen
dc.contributor.authorHernández, Esther
dc.contributor.authorIzquierdo, Angel
dc.contributor.authorLopez-Abente, Gonzalo 
dc.contributor.authorMartínez, Carmen
dc.identifier.citationJ Natl Cancer Inst. 2009; 101(22): 1584–1591.es_ES
dc.description.abstractBACKGROUND: Since the 1980s, Spain experienced two decades of sharply increasing breast cancer incidence. Declines in breast cancer incidence have recently been reported in many developed countries. We examined whether a similar downturn might have taken place in Spain in recent years. METHODS: Cases of invasive female breast cancer were drawn from all population-based Spanish cancer registries that had at least 10 years of uninterrupted registration over the period 1980-2004. Overall and age-specific changes in incidence rates were evaluated using change-point Poisson models, which allow for accurate detection and estimation of trend changes. All statistical tests were two-sided. RESULTS: A total of 80,453 incident cases of invasive breast cancer were identified. Overall age- and registry-adjusted incidence rates rose by 2.9% (95% confidence interval [CI] = 2.7% to 3.1%) annually during the 1980s and 1990s; there was a statistically significant change in this trend in 2001 (95% CI = 1998 to 2004; P value for the existence of a change point <.001), after which incidence declined annually by 3.0% (95% CI = 1.8% to 4.1%). This trend differed by age group: There was a steady increase in incidence for women younger than 45 years, an abrupt downturn in 2001 for women aged 45-64 years, and a gradual leveling off in 1995 for women aged 65 years or older. Separate analyses for registries that had at least 15 years of uninterrupted registration detected a statistically significant interruption of the previous upward trend in breast cancer incidence in provinces that had aggressive breast cancer screening programs and high screening participation rates, including Navarra (change point = 1991, P < .001), Granada (change point = 2002, P = .003), Bizkaia (change point = 1998, P < .001), Gipuzkoa (change point = 1998, P = .001), and Araba (change point = 1997, P = .002). CONCLUSIONS: The recent downturn in breast cancer incidence among Spanish women older than 45 years is best explained by a period effect linked to screening saturation.es_ES
dc.description.sponsorshipConsortium for Biomedical Research in Epidemiology and Public Health (CIBERESP) (AC07-005 to M.P., PM07-004 to R.P-B.) and Carlos III Institute of Health (ISCIII-CIBERESP collaborative agreement “Acción Transversal del Cancer”).es_ES
dc.publisherOxford University Presses_ES
dc.relation.isversionofPublisher's versiones_ES
dc.subject.meshAdult es_ES
dc.subject.meshAge Factors es_ES
dc.subject.meshAge of Onset es_ES
dc.subject.meshAged es_ES
dc.subject.meshAged, 80 and over es_ES
dc.subject.meshBreast Neoplasms es_ES
dc.subject.meshConfidence Intervals es_ES
dc.subject.meshFemale es_ES
dc.subject.meshHumans es_ES
dc.subject.meshIncidence es_ES
dc.subject.meshMass Screening es_ES
dc.subject.meshMiddle Aged es_ES
dc.subject.meshRegistries es_ES
dc.subject.meshSpain es_ES
dc.subject.meshTime Factors es_ES
dc.titleRecent changes in breast cancer incidence in Spain, 1980-2004es_ES
dc.contributor.funderInstituto de Salud Carlos III-ISCIIIes_ES
dc.identifier.journalJournal of the National Cancer Institutees_ES
dc.repisalud.centroISCIII::Centro Nacional de Epidemologíaes_ES

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