A 10 year analysis of breast cancer age distributions in a regional hospital in England and review on current guidelines on breast cancer screening

Ms. Grace Wong, Mr. Olubunmi Odofin

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Breast cancer is the most common cancer in the United Kingdom, contributing 15% of all new cancer cases irrespective of sex, from 2016 to 2018 [1].  Over the past decade in the U.K., the incidence rates of breast cancer have shown an overall increase in trend in all age groups in females, especially in the age groups of 65-69s and 70-79s [5-7]. From 2016-2018, nearly half (48%) of mortality from breast cancer in the U.K. were in the age group of 75 and over, reflecting a higher incidence and lower survival for elderly patients with breast cancer (5-7). 
We performed a retrospective review of the prospectively-maintained database of patients diagnosed with breast cancer (both in-situ and invasive cancers) from 2011 to 2021 in St. Richard’s Hospital, Chichester. The diagnosis and age distribution were analyzed as below. 
From 2011 to 2021, a total of 2272 patients were diagnosed with breast cancer, in average 227 new cases per year. The overall annual number of new breast cancer cases varied from lowest of 169 in the year 2015-2016 to highest of 282 in the year 2013-2014. However, the proportion of age group 71-74 years old increased by 75%; while the proportion of age 71-80 years increased by 24.2%. 
In 2011, the population of older people aged 65 or above living in West Sussex contributed to 20% of the 753,614 population in West Sussex. The population of West Sussex grew to 867,635 over the past decade, while the proportion of this age group (65 years or above) remained similar at 21.1% as 10 years ago. 
In the United Kingdom, women over the age of 71 years have to request mammograms for screening when asymptomatic. Over the past three decades, breast cancer incidence rates have increased overall in all adult age groups in females in the U.K., in women 70-79s by 32% and majority of this women are well and independent.

This is an observational study looking at the trend of age of diagnosis of female breast cancer in a regional hospital in England, seeing an increasing proportion of breast cancer diagnoses at age 71-74. This age group has been included in a number of international guidelines for routine breast cancer screening. Results from randomized trials would provide more evidence on the potential benefits of extending the screening age range in the UK. 

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