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Background <p>Breast and gynaecological cancers represent the leading oncological burden among women worldwide. We aimed to describe long-term mortality trends for these malignancies in Spain over a 26&#xa0;year period, focusing on differences between early-onset (&lt; 50&#xa0;years) and late-onset (≥ 50&#xa0;years) disease.</p> Methods <p>Mortality data (1999–2024) were obtained from the Spanish National Institute of Statistics. Age-standardised mortality rates (ASMRs) were calculated per 100,000 women using the 2013 European Standard Population. Joinpoint regression estimated annual percentage changes (APC) and average annual percentage changes (AAPC) with 95% confidence intervals (CI).</p> Results <p>Total annual deaths rose from 9531 to 11,641, despite declining ASMRs for most sites. Breast cancer mortality decreased consistently (AAPC − 1.4%; 95% CI − 1.5, − 1.3), with a more pronounced reduction in the &lt; 50&#xa0;group (AAPC − 2.5%). Significant ASMR declines were observed for uterus NOS (− 2.3%), ovary (− 0.7%), and cervix uteri (− 0.6%). In the &lt; 50 cohort, ovarian cancer mortality fell sharply (AAPC − 2.1%). Conversely, corpus uteri cancer was the only site showing an increasing trend (AAPC + 0.4%; 95% CI 0.1, 0.8), with a steeper increase observed among women ≥ 50&#xa0;years. Non-monotonic trends were identified for less common gynaecological cancers.</p> Conclusions <p>Mortality rates for breast and most gynaecological cancers in Spain have declined, although absolute deaths have increased. These trends are potentially consistent with advances in prevention and care alongside population ageing. The rise in corpus uteri cancer represents an emerging public health concern potentially associated with increasing metabolic risk factors, highlighting the need for targeted prevention strategies.</p>

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Early- versus late-onset mortality trends in breast and female genital cancers in Spain, 1999–2024

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  • 发表日期：

    2026年6月3日

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  • Lucía Cayuela,
  • Antoni Llueca,
  • Julián Librero,
  • Victoria Achaval,
  • Francisco Herrero Machancoses,
  • Aurelio Cayuela

摘要

Background

Breast and gynaecological cancers represent the leading oncological burden among women worldwide. We aimed to describe long-term mortality trends for these malignancies in Spain over a 26 year period, focusing on differences between early-onset (< 50 years) and late-onset (≥ 50 years) disease.

Methods

Mortality data (1999–2024) were obtained from the Spanish National Institute of Statistics. Age-standardised mortality rates (ASMRs) were calculated per 100,000 women using the 2013 European Standard Population. Joinpoint regression estimated annual percentage changes (APC) and average annual percentage changes (AAPC) with 95% confidence intervals (CI).

Results

Total annual deaths rose from 9531 to 11,641, despite declining ASMRs for most sites. Breast cancer mortality decreased consistently (AAPC − 1.4%; 95% CI − 1.5, − 1.3), with a more pronounced reduction in the < 50 group (AAPC − 2.5%). Significant ASMR declines were observed for uterus NOS (− 2.3%), ovary (− 0.7%), and cervix uteri (− 0.6%). In the < 50 cohort, ovarian cancer mortality fell sharply (AAPC − 2.1%). Conversely, corpus uteri cancer was the only site showing an increasing trend (AAPC + 0.4%; 95% CI 0.1, 0.8), with a steeper increase observed among women ≥ 50 years. Non-monotonic trends were identified for less common gynaecological cancers.

Conclusions

Mortality rates for breast and most gynaecological cancers in Spain have declined, although absolute deaths have increased. These trends are potentially consistent with advances in prevention and care alongside population ageing. The rise in corpus uteri cancer represents an emerging public health concern potentially associated with increasing metabolic risk factors, highlighting the need for targeted prevention strategies.