Achi news desk-
Young women in Canada were more likely to get breast cancer in recent years than three decades ago, according to a new analysis that shows the rates have increased most among patients in their 20s and 30s.
The study, published Friday in the Journal of the Canadian Society of Radiologists, found that young women are still much less likely to develop breast cancer than older people, but their risk is increasing in a way that mirrors findings about cancer. early in other countries and others. parts of the body.
“Twenty years ago, we saw women with breast cancer in their 20s so rarely that it was something we would show on rounds,” said Jean Seely, head of breast imaging at the Ottawa Hospital and one of the authors of the study. “Now we see it regularly.”
The rising rates of breast cancer among Canadian women in their 20s and 30s – when many are in the prime of life, completing post-secondary education, raising young children and climbing the career ladder – is part of a greater tendency towards an increase in the number of cases from the early period. -starting cancers in developed countries around the world.
Early-onset cancer, usually defined as cancer in adults under the age of 50, is becoming more common in at least 14 different types of cancer, including breast, colon and rectal and r pancreas, according to a 2022 study in the journal Nature that asked, “Is early cancer an emerging global epidemic?”
A separate study in BMJ Oncology found that globally, early cancer incidence rates increased by almost 80 percent between 1990 and 2019.
“It’s a mystery,” said Shuji Ogino, professor of pathology at Harvard Medical School and one of the authors of the Nature paper. “But we already know many risk factors for adult cancer. We have good theories.”
At the top of the list of suspects is what Dr. Ogino calls it a “modern lifestyle,” including an obesity-promoting Western diet full of processed foods. Other suspects include lack of exercise, increased alcohol consumption, modern sleeping patterns, stress, and exposure to chemicals and pollutants.
The newspaper drew on Statistics Canada population data and a cancer registry to analyze the number of breast cancer cases in Canada over time, broken down by age group.
The researchers found that, among those in their 20s, there was, on average, 5.7 cases per 100,000 people each year of breast cancer between 2015 and 2019, up from 3.9 cases per 100,000 between 1984 and 1988 – an increase of 45.5 per a hundred
For 30-somethings, there was a 12.5 per cent increase over the same time period. The rate rose to 42.4 cases per 100,000 in the 2015-2019 period from 37.7 cases per 100,000 in 1984-1988.
Rates also increased for some groups of older women, including those in their 40s, but at slower rates than for their younger peers. Fortunately, overall breast cancer death rates have fallen significantly over the same period in Canada as treatments improve and scheduled screening mammogram programs, aimed primarily at women 50 to 74, detect cancer earlier in older women.
With regard to breast cancer, another factor could be the tendency to delay or stop childbearing in rich countries, including in Canada. The newspaper notes that the average age at which Canadian women give birth has risen to 31.6 in 2022, up from 23.5 in 1966. Hormone changes that occur during pregnancy and breastfeeding are thought to reduce the risk of breast cancer.
Anna Wilkinson, a family physician-oncologist at the Ottawa Hospital and another author of the new study, suspects that “a combination of factors” is behind the increase in the number of breast cancer cases in young women.
“We know that things like alcohol exposure and physical inactivity can increase your risk,” he said. “We see that women are having their first child at an older age and they are not having as many children. So those protective factors, like progesterone exposure during pregnancy and breastfeeding, are reduced. “
One factor that does not contribute to the increase is screening. That’s because regular screening mammograms aren’t recommended for average-risk women in their 20s and 30s in Canada.
Dr Seely and Dr Wilkinson, who have been vocal advocates of screening for breast cancer starting at age 40, say the disease remains rare enough in women under 40 that widespread screening would not be a sensible use of resources health care. However, they urged younger women who notice changes to their breasts, including discoloration or lumps, to get their symptoms tested.
In 2019, the most recent year included in the paper, the breast cancer incidence rate was 140.76 cases per 100,000 for Canadian women in their 40s, 42.47 per 100,000 for those in their 30s and 6.07 for women in their 20s. .
The Canadian Task Force on Preventive Health Care, which publishes national recommendations for primary care providers, currently recommends against screening mammograms for average-risk women aged 40-49, saying the risks of false positives and overtreatment are outweigh the benefits for that age group. The task force is expected to issue a much-anticipated update to its guidelines this spring.
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