Population-level trends in breast cancer incidence, staging, and mortality in Armenia.

Abstract

e22581 Background: Armenia, an Upper-Middle Income Country in the South Caucasus, has one of the highest breast cancer mortality rates in the world, with a mortality-to-incidence ratio (MIR) substantially exceeding that of peer countries. However, longitudinal data on incidence, stage at diagnosis, and mortality are limited. We analyzed national population data to evaluate trends in breast cancer epidemiology in Armenia. Methods: We conducted a retrospective, population-level analysis using publicly available statistical yearbooks from Armenia’s National Institute of Health from 2010–2024. Data were extracted on breast cancer incidence (2010-2024), stage at diagnosis (2016-2024), and mortality (2019-2024). Descriptive and regression analyses were performed to evaluate temporal trends across the study period. The study was reviewed by the UMass Chan institutional review board and deemed exempt from human subjects research. Results: Breast cancer incidence rates increased over the study period, rising from approximately 32 per 100,000 in 2010 to 54 per 100,000 in 2024. In contrast, breast cancer mortality rates did not change meaningfully from 2019-2024 (Table 1). Consequently, the MIR has declined over time, from 33.2 in 2019 to 26.4 in 2024. In 2020, a transient decrease in reported incidence led to a peak in the calculated MIR. Analysis of stage distribution demonstrated a shift toward more advanced disease, with a statistically significant decline in the proportion of Stage I/II diagnoses and a corresponding significant increase in the proportion of Stage III diagnoses (Table 1). Changes in the proportion of Stage IV diagnoses were insignificant. Conclusions: Breast cancer incidence in Armenia has increased over time, while mortality has remained stable, resulting in a declining MIR ratio. However, the observed shift toward later-stage diagnosis, particularly stage III disease, highlights persistent challenges in early detection and timely diagnosis. Epidemiology of breast cancer in Armenia over 6 years. Year 2019 2020 2021 2022 2023 2024 Incidence Rate 1 44.7 37.7 44.8 47.9 51.0 53.9 Mortality Rate 1 14.9 14.8 14.7 14.5 14.9 14.2 Mortality-to-Incidence Ratio 0.33 0.39 0.33 0.30 0.29 0.26 Stage I/II (%) 76.8 65.8 56.4 66.3 56.1 63.1 Stage III (%) 6.9 15.8 25.1 18.4 22.5 21.4 Stage IV (%) 16.3 18.5 18.5 15.3 21.5 15.5 1 Per 100,000 people. Calculated using population data published by the World Bank.