Trends in breast cancer incidence and mortality, clinical diagnosis and treatment in the light of the contemporary demographic changes in Germany and Poland, 2006–2016
More details
Hide details
Medical Student, Charité-Universitätsmedizin Berlin, Germany
Institute of Geography, Kazimierz Wielki University, Bydgoszcz, Poland
Institute of Geographical Sciences, Freie University Berlin, Germany
Institute of Spatial Management and Geography, Faculty of Geoengineering, University of Warmia and Mazury in Olsztyn, Poland
Submission date: 2020-05-26
Final revision date: 2020-10-02
Acceptance date: 2020-10-02
Online publication date: 2020-10-30
Corresponding author
Marie Thöle   

Charité-Universitätsmedizin, Charitéplatz 1, 10117 Berlin. Tel.: +493315818833.
Pol. Ann. Med. 2020;27(2):159-167
Trends in cancer incidence and mortality are determined by contemporary demographic processes. Breast cancer in women is a particular threat. In Germany, the chances of survival after the diagnosis of cancer are among the highest in Europe. The understanding of the latest trends in breast cancer incidence and mortality in Germany and the presentation of the latest screening options, treatment and prevention methods can be used to improve the control of breast cancer in the future.

The aim of the research was to present trends in cancer incidence and mortality, with particular emphasis on breast cancer in women in Germany and Poland on the background of contemporary demographic changes relating to the process of population ageing in 2006–2016. The clinical diagnostic process, the treatment of breast cancer and potential risk factors and prevention methods were described.

Material and methods:
In the publication the basic statistical indicators have been applied: absolute numbers, percentages, crude rates, age-standardized rates, and demographic aging index.

Results and discussion:
The cancer mortality in Poland was much higher than in Germany, which is associated with the low five-year survival rate of cancer patients in Poland. The breast cancer was characterized by the highest dynamics in incidence growth with a persistent mortality level.

Over the last two decades, breast cancer outcomes of patients have improved significantly due to highly individualized breast cancer therapies and the development of breast cancer treatment options such as immunotherapy, hormone receptor-based therapy and HER2 status-based therapy. The main risk factors are age, hormonal situation and inherited risk genes.

This research was supported by medical students and researchers from German and Polish universities. We thank the Robert Koch Institute, the Charité-Universitätsmedizin Berlin and the Charité Medical Library for the opportunity to use medical literature and scientific databases.
None declared.
Winter A, Vohmann C, Wawroschek F, Kieschke J. Increase in uro-oncological health care needs due to demographic change. Urologe. 2015;54(9):1261–1268 [in German].
Fiebig J, Kraywinkel K. Declining cancer mortality in Germany – what is the role of cancer incidence trends? Public Health Forum. 2018;26(3):220–224 [in German].
Kraywinkel K, van Orschot B. [Changes in survival rates and tumor characteristics with increasing age: results from population-based cancer registries]. Onkologie. 2018;25(9):741–747 [in German].
Rowland JH, Hewitt M, Ganz PA. Cancer survivorship: a new challenge in delivering quality cancer care. J Clin Oncol. 2006;24(32):5101–5104.
Grzelak-Kostulska E. Seniors in Poland in light of modernization processes. Toruń: UMK; 2016:102–104 [in Polish].
Ministry of Health. Cancer in Poland in 2016. Warszawa: Ministry of Health. 2018;5–9,19–25 [in Polish].
Cancer in Germany in 2015/2016 and 2005/2006. Robert Koch-Institut (RKI) Berlin. Gesundheitsberichterstattung des Bundes. 2019;19–24 [in Germany].
Thöle M, Jezierska-Thöle A. Life expectancy and mortalityrates in Poland and Germany – a comparative analysis. The 13th International Days of Statistics and Economics. 2019;1537–1547.
Statistics Poland. Accessed: 30 October 2020.
Statistisches Bundesamt. Accessed: 30 October 2020.
Gwiaździńska-Goraj M, Goraj S. Transformation of demographic characteristics of the rural population of the Warmia and Mazury voivodship. The 13th International Days of Statistics and Economics, 2015;498-510.
Jezierska-Thöle A. Changes in resources and quality of human capital in rural areas of Poland and East Germany. Rural Studies. 2016;41:167–183. [in Polish]
Polish National Cancer Registry. Accessed: 30 October 2020.
Cancer in Germany. www. Accessed: 30 October 2020. 13 Jezierska-Thöle A. Janzen J. Changes in resources and quality of human capital in rural areas of Poland and East Germany. The 10th International Days of Statistics and Economics, 2016;723-733.
Fuller MS, Lee CI, Elmore JG. Breast cancer screening: an evidence-based update. Med Clin North Am. 2015;99(3):451–468.
Berry DA, Cronin KA, Plevritis SK, et al. Effect of screening and adjuvant therapy on mortality from breast cancer. N Engl J Med. 2005;353(17):1784–1792.
Friedewald SM, Rafferty EA, Rose SL, et al. Breast cancer screening using tomosynthesis in combination with digital mammography. JAMA. 2014;311(24):2499–2507.
Lehman CD. Clinical indications: what is the evidence? Eur J Radiol. 2012;81(1):82–84.
McDonald ES, Clark AS, Tchou J, Zhang P, Freedman GM. Clinical diagnosis and management of breast cancer. J Nucl Med. 2016;57(1):9–16.
Dorn PL, Al-Hallaq HA, Haq F, et al. A prospective study of the utility of magnetic resonance imaging in determining candidacy for partial breast irradiation. Int J Radiat Oncol Biol Phys. 2013;(85):615–622.
Perou CM, Sorlie T, et al. Molecular portraits of human breast tumors. Nature. 2000;406:747–752.
Huang B, Warner M, Gustafsson JA. Estrogen receptors in breast carcinogenesis and endocrine therapy. Mol Cell Endocrinol. 2015;418(Pt 3):240–244.
Bennett NC, Farah CS. Next-generation sequencing in clinical oncology: next steps towards clinical validation. Cancers (Basel). 2014;6(4):2296–2312.
Polish Oncological Guidelines. Accessed: 30 October 2020.
Jastrzębski T, Nachmann-Jastrzębska M, Drucis K, et al. Oncological service for patients and doctors,, Breast Cancer. Gdański Uniwersytet Medyczny. 2020. [in Polish].
Waks AG, Winer EP. Breast cancer treatment: A review. JAMA. 2019;321(3):288–300.
Giuliano AE, Connolly JL, Edge SB, et al. Breast cancer – Major changes in the American Joint Committee on Cancer eighth edition cancer staging manual. CA Cancer J Clin. 2017;67(4):290–303.
Jonczyk MM, Jean J, Graham R, Chatterjee A. Surgical trends in breast cancer: a rise in novel operative treatment options over a 12 year analysis. Breast Cancer Res Treat. 2019;173(2):267–274;2019.
Tryfonidis K, Zardavas D, Katzenellenbogen BS, Piccart M. Endocrine treatment in breast cancer: Cure, resistance and beyond. Cancer Treat Rev. 2016;50:68–81.
Didkowska J, Wojciechowska U. et al. National Cancer Registry, About Cancer, Breast Cancer in Women. 2020. [in Polish].
Palesh O, Scheiber C, Kesler S, Mustian K, Koopman C, Schapira L. Management of side effects during and post‐treatment in breast cancer survivors. Breast. 2018;24(2):167–175.
Zentrum für Krebsregisterdaten, Robert-Koch-Institut. Brustdrüse, Krebs in Deutschland. 2019:78–81 [in German].
Iqbal J, Amir E, Rochon P, et al. Association of the timing of pregnancy with survival in women with breast cancer. JAMA Oncol. 2017;3(5):659–665.
Iversen L, Sivasubramaniam S, Lee A, Fielding S, Hannaford PC. Lifetime cancer risk and combined oral contraceptives: The Royal College of General Practitioners’ Oral Contraception Study. Am J Obstet Gynecol. 2017;216(6):580.e1-580.e9.
Schwingshackl L, Hoffmann G. Adherence to Mediterranean diet and risk of cancer: An updated systematic review and meta-analysis of observational studies. Cancer Med. 2015;4(12):1933–1947.
American Cancer Society. Lifestyle-related Breast Cancer Risk Factors. and-prevention/lifestyle-related-breast-cancer-risk-factors.html. Accessed: October 19, 2020.
Semmler L, Reiter-Brennan C, Klein A. BRCA1 and breast cancer: A review of the underlying mechanisms resulting in the tissue-specific tumorigenesis in mutation carriers. J Breast Cancer. 2019;22(1):1–14.
Journals System - logo
Scroll to top