Breast cancer is the most commonly diagnosed malignant tumor among women in Estonia. In 2004, the country launched a national screening program aimed at early detection and reducing mortality. Women aged 50-70 and 74 are invited to participate in the screening every two years.

However, the program's target age range has been narrower than international recommendations and participation rates remain below the recommended 70 percent threshold. For instance, in 2015, only half of eligible women participated, with the 60 percent participation mark first surpassed in 2022.

According to Aleksei Baburin, a researcher in the epidemiology and biostatistics department at the National Institute for Health Development, his doctoral research sought to evaluate long-term trends in breast cancer incidence, mortality and survival in Estonia. His study analyzed these trends in the context of societal and healthcare system changes and the implementation of the screening program.

Using data from the Estonian Cancer Registry and the Causes of Death Registry, Baburin applied various statistical methods to identify trends. His findings reveal that breast cancer incidence in Estonia is gradually increasing, with the disease being detected more often at earlier stages. Simultaneously, the incidence of advanced-stage breast cancer has decreased.

Since the late 1990s, breast cancer mortality has been declining, particularly among women aged 40-79. While mortality rates in earlier birth cohorts rose with age, those invited to screenings showed stable or declining mortality after reaching the target screening age.

Notably, mortality rates have decreased not only among the screening target group but also among younger women since the program's inception. Over the past 30 years, survival rates for breast cancer patients have improved across all age groups, with the most significant gains observed in patients diagnosed at stages III and IV.

Despite low participation rates, Baburin credits the screening program, alongside increased awareness, improved diagnostics and advances in treatment, for significantly reducing breast cancer mortality in Estonia.

To achieve further reductions, Baburin highlights the need to address risk factors, enhance the quality of screening programs and ensure faster diagnosis for symptomatic patients. Additionally, access to modern treatment methods and psychosocial support should be made available to all cancer patients.

Baburin's doctoral dissertation, "Breast Cancer Incidence, Mortality, and Survival in Estonia in the Context of Healthcare System Changes and Screening," is available in the University of Tartu's digital repository. The research was supervised by Kaire Innos, a senior researcher at the National Institute for Health Development, and Katrin Lang, an associate professor of epidemiology at the University of Tartu.

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