Breast cancer - UK incidence statistics

Breast cancer is the most common cancer in the UK despite the fact that it is rare in men. In 2008, there were 48,034 new cases of breast cancer diagnosed in the UK: 47,693 (over 99%) in women and 341 (less than 1%) in men.

Table 1.11-4 shows the numbers and rates of new cases of breast cancer in the UK and its constituent countries. The lowest rates are recorded in Northern Ireland and this has been a consistent pattern since Northern Ireland cancer registration rates became available in 1993.19

Table 1.1: Breast Cancer (C50), Number of New Cases, Crude and European Age-Standardised (AS) Incidence Rates per 100,000 Population, UK, 2008

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*95% LCL and 95% UCL are the 95% lower and upper confidence limits around the AS Rate

Section updated 18/07/11

Breast cancer is by far the commonest cancer in women in the UK accounting for 31% of all cases in women. The next most common cancer in women is lung cancer, with 17,960 cases (12% of total) in 2008. So nearly a third of all new cancers in women are breast cancers. It has been estimated that the lifetime risk of developing breast cancer in 2008 is 1 in 1,014 for men and 1 in 8 for women in the UK This was done using the AMP method.5  Find out breast cancer risk by age.

Section updated 20/06/11

Breast cancer risk is strongly related to age,with 81% of cases occurring in women aged 50 years and over. Nearly half (48%) of cases of breast cancer are diagnosed in the 50-69 age group (Figure 1.11-4): these women and those aged 70 are targeted in the national screening programme. In 2006, the NHS Breast Screening Programme announced its intention to extend the age range of women eligible for breast screening to ages 47 to 73. The extension which is being carried out as a randomised trial is due to be completed by 2016. For more information on breast cancer screening go to the screening section.

Figure 1.1: Breast Cancer (C50), Average Number of New Cases per Year and Age-Specific Incidence Rates, UK, 2006-2008

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Although very few cases of breast cancer occur in women in their teens or early 20s, breast cancer is the second most commonly diagnosed cancer in women under 35. Among women aged 35-39 over 1,300 cases of breast cancer are diagnosed each year. Breast cancer incidence rates generally increase with age, supporting a link with hormonal status.

Section updated 18/07/11

In 2008 it was estimated that worldwide, 1.38 million women were diagnosed with breast cancer, accounting for around a tenth (10.9%) of all new cancers and nearly a quarter (23%) of all female cancer cases. 6 Female breast cancer incidence rates vary considerably, with the highest rates in Europe and the lowest rates in Africa and Asia (Figure 1.2).6

Figure 1.2: Breast Cancer (C50), World Age-Standardised Incidence and Mortality Rates, World Regions, 2008 Estimates

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An estimated 332,670 new cases of breast cancer occurred in the countries of the European Union (EU-27) in 2008 7, and an estimated 182,460 occur in the USA each year 37. Figure 1.3 shows breast cancer incidence and mortality rates in the countries of the EU.

Figure 1.3: Breast Cancer (C50), European Age-Standardised Incidence and Mortality Rates, EU27 Countries, 2008 Estimates

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The risk for women who migrate from low to high risk countries typically increases suggesting a strong effect for lifestyle or environmental factors. For example, Japanese migrants to the USA experience rapidly increasing breast cancer rates. 8, 9

An analysis of cancer incidence and mortality from 1991 to 2000 within the UK and Ireland reported relatively little geographical variation for either breast cancer rate.10 At the regional and country level, the European age-standardised rates (EASR)11 for breast cancer incidence ranged from 97 per 100,000 in Ireland to 116 per 100,000 in the South East of England. In England rates were slightly higher than average in the south and slightly lower than average in the north but very few areas  differed by more than 10% from the average. 

In Ireland rates were generally more than 10% below the average. A more recent examination of incidence rates within the UK for 2005 also reported only modest variation in breast cancer incidence for the majority of cancer networks.12

Section updated 18/07/11

Breast cancer is one of the few cancers where incidence rates are higher for more affluent women and there is a clear trend of decreasing rates from least to most deprived groups.13 An analysis of incidence rates in Scotland for patients registered from 2001-2005 showed a 6% difference between the rates in the least deprived (EASR 118.7 per 100,000) and the most deprived (EASR 111.0 per 100,000) areas. 14

In England, a study of incidence for patients diagnosed between 1998 and 2003 by socio-economic group and region, also reported modest differences between socio-economic groups with the highest rates for the most affluent groups.15 The most recent study in England comparing deprivation for cancer patients in two time periods, 1995-99 and 2000-04, reported that rates in the most deprived groups in 2000-04 were around 20% lower than in the most affluent.16 If all groups had the rates of the most affluent then there would be an additional 2,500 new breast cancer cases each year in England.16 These results are not unexpected as many of the risk factors for breast cancer, for example, late first pregnancy and lower parity are generally more prevalent in the more affluent groups in society.

Section updated 20/06/11

The incidence of breast cancer has been increasing for many years in economically developed countries 17,18. From the late 1970s until the introduction of breast screening, the increase in Britain was around 2% per annum 19. The introduction of the national screening programme in 1988 led to a transient additional increase in incidence as a prevalent pool of undiagnosed cancers were detected (Figure 1.41-3).

Over the thirty year period 1979-2008 in Britain, the European age-standardised incidence rate (EASR) for women increased by more than half (65%) from 75 per 100,000 in 1979 to 124 per 100,000 in 2008. Over the same time period the annual number of new cases of breast cancer in women almost doubled from 23,876 to 46,537 in Britain.(Figure 1.41-3).

Figure 1.4: Breast Cancer (C50), European Age-Standardised Incidence and Mortality Rates, Females, Great Britain, 1975-2008

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Figure 1.5 shows the breast cancer incidence trend for the UK. In the last ten years in the UK, the EASR for women has increased by 3.6% from 120 per 100,000 in 1999 to 124 per 100,000 in 2008, while the numbers of cases rose from 42,386 to 47,693, an increase of 13%.

Figure 1.5: Breast Cancer (C50), European Age-Standardised Incidence Rates, UK, 1993-2008

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During the 1990s the increase in the use of hormone replacement therapy (HRT) is thought to have also contributed to the increase in incidence 20. Analysis of incidence trends by deprivation group showed that incidence rose more rapidly in affluent women than among deprived women between 1986 and 1999, and the higher use of HRT in affluent women may have contributed to this21.

The trends by age-group show clearly that the steep increase in incidence following 1988 was largely confined to women aged 50-64 who were invited to join the breast screening programme (Figure 1.61-3). The most recent rates show a downturn for this age-group. 

Figure 1.6: Breast Cancer (C50), European Age-Standardised Incidence Rates, by Age, Great Britain, 1975-2008

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A steep decrease in incidence since 2002 for women aged 50 or older has been noted in the USA and linked to the sudden drop in HRT use following publication of the Women's Health Initiative (WHI) Trial results 18, 22-24.  (The WHI trial was a randomised controlled trial of estrogen-plus-progestin use in post-menopausal women for prevention of chronic disease. The trial was stopped early in July 2002 because risks exceeded benefits).The most recent WHI study reports that the decrease in breast cancer incidence in the over 50s is most likely to be due to the reduced use of HRT rather than decreased uptake of screening and also that the risk of breast cancer after stopping HRT seems to fall very quickly 25. 

Similar trends have been seen in other countries 26. In Scotland an analysis of breast cancer incidence and HRT use also reports a reduction in incidence for women aged 50-64 and a dramatic decrease in HRT use consistent with this theory 27. This analysis also showed a gradual increase since 1999 in prescriptions of raloxifene - a selective oestrogen receptor modulator that has been shown to reduce risk of oestrogen-receptor-positive breast cancer and is also used to treat osteoporosis 39

In the UK as a whole, the use of hormonal preparations rose steeply from 1992 to reach a maximum in 2000-01 when approximately 25% of women aged 45-69 were using them; the percentage has fallen to half that in 2006 28. It has been estimated that due to the fall in the use of HRT, there were 1,400 fewer cases of breast cancer at ages 50-59 in the UK in 2005 than would have occurred if no such fall in use had happened 28.The recent steep rise in rates for women aged 65-69 is almost certainly caused by the introduction of national breast cancer screening for this age-group (Figure 1.7 27, 38).

Figure 1.7: European Age-Standardised Incidence Rates of Invasive Breast Cancer, by Age Group, in Scottish Women (1980-2005)  and numbers of dispensed items of HRT and Raloxifene (1993-2005)

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Projections for Britain from 2005 until 2024 show that the EASR is expected to increase from 119 per 100,000 in 2000-04 to 124 per 100,000 in 2020-24. Over the same time period, the average number of cases per year will rise from 41,900 to 55,700 new cases, that is, more than double the number of cases registered in the late 1970s 29 (the projected number of cases in the UK in 2024 is 57,000).

The historically lower rates in central and Eastern Europe and the Far East have begun to rise rapidly30-32. For example, in Japan, where breast cancer incidence rates have more than doubled over the last 40 years, breast cancer is now the most common form of cancer in women, and rates are likely to continue rising 33.

China, with a fifth of the world’s female population, has already seen dramatic rises in incidence in some cities such as Shanghai and if these trends spread to the rest of the country, a substantial increase in the number of cases is predicted 34. These increases have been linked to changes in reproductive behaviour (in China the average birth rate fell from 5.9 births per woman in 1970 to 2.9 in 1979 and 1.7 in 2004 35) and lifestyle risk factors such as weight gain, alcohol consumption and the use of hormone replacement therapy.

Section updated 18/07/11

Prevalence data relate to those people in the UK population who were alive on a specific date having previously been diagnosed with cancer. As the incidence of breast cancer is high, and five-year survival rates are over 80%, many women are alive who have been diagnosed with breast cancer. Estimates based on diagnoses up to the end of 2004 applied to the population in 2008 suggests that around 550,000 women are alive in UK who have had a diagnosis of breast cancer 36. This equates to almost 2% of the total female population and nearly 10% of the population aged 65 years and older.

The latest analysis shows that on 31st December 2006, almost 298,000 people were alive up to ten years after being diagnosed with breast cancer, 99% of these are women 40. Table 1.2 shows the one, five and ten year prevalence by sex for breast cancer.

Table 1.2: Breast Cancer (C50) Prevalence in the UK, at 31st December 2006

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Section updated 22/06/11

Some tumours detected in the breast are non-invasive. The natural history of these tumours is not fully known but there is evidence that they carry a raised risk for invasive cancer41, and sometimes they are thought of as being pre-invasive disease or an early cancer. In 2008, there were 5,694 women diagnosed with an in situ breast carcinoma (ICD-10 D05) in the UK.1-4

There are two main types of in situ carcinoma, ductal and lobular. Of the 5,558 women diagnosed in Great Britain in 2008, 4,650 (84%) had ductal carcinoma in situ (DCIS) disease and 509 (9%) had lobular carcinoma in situ disease. A further 399 women in Great Britain were diagnosed with other or unspecified in situ carcinoma of the breast.1-3

Section updated 22/12/11