Paradoxes of breast cancer incidence and mortality in two corners of Europe

Background: Breast cancer incidence is rising globally. Mortality rates show a heterogenous pattern, where geographical disparities might indicate influence of health policy, behavior and care provision. Early detection and treatment have been proven to have a profound impact on prognosis. Methods Breast cancer data from Sweden and Crete was derived from registries. Incidence and mortality were expressed as Age-Standardized Incidence Rates (ASIR), Age-Standardized Mortality Rates (ASMR) and survival as intervals of three consecutive enrolling years. Findings Incidence of breast cancer has for decades risen in Sweden and also on Crete. In 2019, ASIR was 217.5 in Sweden and 58.9 on Crete, (p < 0.001). Mortality rates, however, showed opposite trends. ASMR was higher on Crete (25/100.000 person years) than in Sweden (17/100.000 person years) (p = 0.04). ASMR has fallen in Sweden from 25.5 to 16.8 in the period 2005–2019, while on Crete, ASMR continued to rise from 22.1 to 25.3. Since the early 1980’s, a successive rise in survival rate in Sweden was seen with a 5-year survival rate of 92% since 2015, but a converse development on Crete with 85% 5-year survival rate during the same period. Interpretation Breast cancer incidence is slowly rising in both studied regions, but the mortality increase on Crete in contrast to Sweden where mortality decrease. The findings reveal an improvement of the survival rate for Swedish breast cancer patients, while survival trends on Crete is falling. This may be related to the national breast screening program established in Sweden, but not in Greece.