Is breast cancer really increasing among young women?

When it comes to breast cancer among young women, that is, those under 50, there seems to be a big gap between perception and epidemiological reality. This is clearly stated by GISMA, the Italian Mammography Screening Group , which analyzed the data currently available in tumor registries.

The origin of the alarm

The concern stems from a study published in BMJ Oncology, which reported a 79% increase in juvenile cancer cases and a 27% increase in mortality globally over the past thirty years. However, these figures represent a global average and do not reflect trends in Europe or Italy, where incidence remains stable and mortality is declining, reports Gisma.

The situation is also different overseas, where reports of an increase in incidence in this age group have long been reported. The latest is reported in a Washington Post article: according to an analysis of SEER and CDC data, the incidence rate of breast cancer in the 15-49 age group has increased from approximately 24 cases per 100,000 people (1999-2002) to approximately 30 cases per 100,000 (2018-2022). Overall, cancers (all cancers) in people under 50 have increased by 10% in the last 25 years, and scientists are investigating the role of the so-called exposome, or everything we come into contact with, even before birth, as well as our lifestyle.

The Italian data

But let's return to Italy. According to studies by AIRTUM (Italian Association of Cancer Registries), between 2008 and 2017, there was a slight average annual increase in breast cancer among women aged 20-49, of 0.5%, concentrated mainly in the South and the Islands and limited to the 40-49 age group.

More specifically, the Airtum study published in 2024 in Tumori Journal shows that, among women aged 20-49, breast cancer incidence rates increased steadily from 2008 (82.4) to 2014 (86.2) but remained unchanged thereafter (86.5 in 2017), with an overall increase of 5%. For comparison with other cancers with a sharp increase, the incidence of melanoma grew by 40% in the same period in the same age group.

If we then analyze the data based on two age groups - 20-39 and 40-49 - we see that in the first the rate has remained stable at around 30 diagnoses per 100,000 women, while in the second there has been a slight increase, from 179 per 100,000 women in 2008 to 188 per 100,000 in 2017).

Another study, covering the period 2013-2017, highlighted a 0.8% annual increase in the under-50 population, but again this was largely confined to Central and Southern Italy (+1.7%). Long-term data collected in Veneto (1987-2019) and the province of Reggio Emilia (1996-2021) confirm the incidence's stability, with an initial phase of growth that ended in the early 2000s. Other Italian registries also fail to report exponential increases.

Why cases may appear to be rising sharply

Epidemiologists explain that a slight increase in diagnoses does not equate to a real increase in the risk or aggressiveness of the disease. More often, it is a consequence of increased availability of diagnostic tests and screening. In Italy, organized mammography screening for women aged 45-49 is available only in some regions, but in other areas, many women access it spontaneously, resulting in earlier diagnoses and improved outcomes.

Indicators such as mortality (declining), survival (increasing) and stage at diagnosis (increasingly earlier) confirm that advances in medicine and prevention are reducing the impact of the disease.

No alarm, but invest in prevention

"There is no evidence of a breast cancer epidemic among young Italian women," GISMA emphasizes. The data show stability, with significant progress in prevention and treatment. The challenge remains the same: strengthening the culture of prevention and supporting screening programs, while avoiding alarmism.