Cancer Causes & Control

, Volume 23, Issue 7, pp 1047–1053 | Cite as

Breast cancer incidence in Mongolia

  • Rebecca Troisi
  • Dalkhjav Altantsetseg
  • Ganmaa Davaasambuu
  • Janet Rich-Edwards
  • Dambadarjaa Davaalkham
  • Steinar Tretli
  • Robert N. Hoover
  • A. Lindsay Frazier
Original paper



Data on international variation in breast cancer incidence may help to identify additional risk factors. Substantially lower breast cancer rates in Asia than in North America and Western Europe are established, but differences within Asia have been largely ignored despite heterogeneity in lifestyles and environments. Mongolia’s breast cancer experience is of interest because of its shared genetics but vastly different diet compared with other parts of Asia.


Age-standardized breast cancer incidence and mortality rates obtained from the International Association of Cancer Registries are presented for several Asian countries. Mongolian incidence rates obtained from its cancer registry describe incidence within the country.


Breast cancer incidence in Mongolia (age standardized 8.0/100,000) is almost a third of rates in China (21.6/100,000), and over five times that of Japan (42.7/100,000) and Russia (43.2/100,000). Rates within Mongolia appear to have increased slightly over the last decade and are higher in urban than rural areas (annual percentage increase of age-standardized rates from 1998 to 2005 was 3.60 and 2.57 %, respectively). The increase in breast cancer incidence with age plateaus at menopause, as in other Asian populations.


Mongolia’s low breast cancer incidence is of particular interest because of their unusual diet (primarily red meat and dairy) compared with other Asian countries. More intensive study of potential dietary, reproductive and lifestyle factors in Mongolia with comparison to other Asian populations may provide more clarity in what drives the international breast cancer rate differences.


Mongolia Breast cancer Urban–rural Asia International 



We thank Ms. Narantuya Khad, senior officer and research fellow in the Public Health Sector Policy Research Unit of the Health Department, for her work at the Registry. This work was supported by the Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, US Department of Health and Human Services.

Conflict of interest

The authors declare they have no conflict of interest.

Supplementary material

10552_2012_9973_MOESM1_ESM.docx (19 kb)
Supplementary material 1 (DOCX 19 kb)


  1. 1.
    Ferlay J, Shin HR, Bray F, Forman D, Mathers C, Parkin DM (2008) GLOBOCAN, cancer incidence and mortality worldwide: IARC CancerBase No. 10 [Internet]. International Agency for Research on Cancer,Lyon, France; 2010. Available from:
  2. 2.
    Ziegler RG, Hoover RN, Pike MC et al (1993) Migration patterns and breast cancer risk in Asian-American Women. J Natl Cancer Inst 85:1819–1827PubMedCrossRefGoogle Scholar
  3. 3.
    Doll R, Payne P, Waterhouse J (eds) (1966) Cancer incidence in five continents: a technical report. Springer, Berlin for UICCGoogle Scholar
  4. 4.
    Segi M (1960) Cancer mortality for selected sites in 24 countries (1950–57). Tohoku University School of Public Health, SendaiGoogle Scholar
  5. 5.
    Dulamsuren S (ed) Annual Health Report 2004: Health Indicators. Department for Health Statistics and Information, Mongolian Ministry of Health, National Center for Health Development, UlaanbaatarGoogle Scholar
  6. 6.
    Surveillance epidemiology and end results. World Standard Million.
  7. 7.
    US Central Intelligence Agency (2008) World factbook, on-line, updated as of Oct 2008Google Scholar
  8. 8.
    Shin H-R, Joubert CC, Boniol M et al (2010) Recent trends and patterns in breast cancer incidence among Eastern and Southeastern Asian women. Cancer Causes Control 21:1777–1785PubMedCrossRefGoogle Scholar
  9. 9.
    Wu AH, Ziegler RG, Pike MC et al (1996) Menstrual and reproductive factors and risk of breast cancer in Asian-Americans. Br J Cancer 73:680–686PubMedCrossRefGoogle Scholar
  10. 10.
    Ziegler RG, Hoover RN, Nomura AM et al (1996) Relative weight, weight change, height, and breast cancer risk in Asian-American women. J Natl Cancer Inst 88:650–660PubMedCrossRefGoogle Scholar
  11. 11.
    Ursin G, Wu AH, Hoover RN et al (1999) Breast cancer and oral contraceptive use in Asian-American women. Am J Epidemiol 150:561–567PubMedCrossRefGoogle Scholar
  12. 12.
    Wu AH, Ziegler RG, Nomura AMY et al (1998) Soy intake and risk of breast cancer in Asians and Asian Americans. Am J Clin Nutr 68:1437S–1443SPubMedGoogle Scholar
  13. 13.
    Bernstein L, Yuan JM, Ross RK et al (1990) Serum hormone levels in pre-menopausal Chinese women in Shanghai and white women in Los Angeles: results from two breast cancer case-control studies. Cancer Causes Control 1:51–58PubMedCrossRefGoogle Scholar
  14. 14.
    Falk RT, Fears TR, Hoover RN et al (2002) Does place of birth influence endogenous hormone levels in Asian-American women? Br J Cancer 87:54–60PubMedCrossRefGoogle Scholar
  15. 15.
    Key T, Appleby P, Barnes I, Reeves G, Endogenous Hormones and Breast Cancer Collaborative Group (2002) Endogenous sex hormones and breast cancer in postmenopausal women: reanalysis of nine prospective studies. J Nat Cancer Inst 94:606–616PubMedCrossRefGoogle Scholar
  16. 16.
    Sandagdorj T, Sanjaajamts E, Tudev U, Oyunchimeg D, Ochir C, Roder D (2010) Cancer incidence and mortality in Mongolia—national registry data. Asia Pac J Cancer Prev 11:1509–1514Google Scholar
  17. 17.
    Deapen D, Liu L, Perkins C, Bernstein L, Ross RK (2002) Rapidly rising breast cancer incidence rates among Asian-American women. Int J Cancer 99:747–750PubMedCrossRefGoogle Scholar
  18. 18.
    Henderson BE, Bernstein L (1991) The international variation in breast cancer rates: an epidemiological assessment. Br Cancer Res Treat 18:s11–s17CrossRefGoogle Scholar
  19. 19.
    Epplein M, Zheng Y, Zheng W et al. (2010) Quality of life after breast cancer diagnosis and survival. J Clin Oncol (published online before print)Google Scholar
  20. 20.
    Hebert JR, Ghumare SS, Gupta PC (2006) Stage at diagnosis and relative differences in breast and prostate cancer incidence in India: comparison with the United States. Asian Pac J Cancer Prev 7:547–555PubMedGoogle Scholar
  21. 21.
    Lvov DK, Samokhvalov EI, Tsuda F et al (1996) Prevalence of hepatitis C virus and distribution of its genotypes in Northern Eurasia. Arch Virol 141:1613–1622PubMedCrossRefGoogle Scholar
  22. 22.
    Baatarkhuu O, Kim DY, Ahn SH et al (2008) Prevalence and genotype distribution of hepatitis C virus among apparently healthy individuals in Mongolia: a population-based nationwide study. Liver Int 28:1389–1395PubMedCrossRefGoogle Scholar
  23. 23.
    Batnasan N, Dorgojov Y (eds) Human Development Report 2003 Mongolia. Urban–rural disparities in Mongolia. United Nations Development Programme and the Government of MongoliaGoogle Scholar
  24. 24.
    Matsuno RK, Anderson WF, Yamamoto S et al (2007) Early- and late-onset breast cancer types among women in the United States and Japan. Cancer Epidemiol Biomarkers Prev 16:1437–1442PubMedCrossRefGoogle Scholar
  25. 25.
    United Nations Development Programme: Ulaanbaatar, Mongolia (2007) Mongolian STEPS Survey on the prevalence of noncommunicable disease risk factors 2006. World Health OrganizationGoogle Scholar
  26. 26.
    Food and Agricultural Organization of the United Nations. Dietary energy supply [1994–1996] in East and Southeast AsiaGoogle Scholar
  27. 27.
    Lips P (2007) Vitamin D status and nutrition in Europe and Asia. J Steroid Biochem Mol Biol 103:620–625PubMedCrossRefGoogle Scholar
  28. 28.
    Shao T, Klein P, Grossbard ML (2012) Vitamin D and breast cancer. Oncologist 17:36–45PubMedCrossRefGoogle Scholar
  29. 29.
    Graham MJ, Larsen U, Xu X (1999) Secular trend in age at menarche in China: a case study of two rural counties in Anhui Province. J Biosoc Sci 31:257–267PubMedCrossRefGoogle Scholar
  30. 30.
    Bao P-P, Shu XO, Gao Y-T et al (2011) Association of hormone-related characteristics and breast cancer risk by estrogen receptor/progesterone receptor status in the Shanghai Breast Cancer Study. Am J Epidemiol 174:661–667PubMedCrossRefGoogle Scholar
  31. 31.
    Aassve A, Altankhuyag G (2002) Changing patterns of Mongolian fertility at a time of social and economic transition. Stud Family Plan 33:165–172CrossRefGoogle Scholar
  32. 32.
    Riley NE (2004) China’s population: new trends and challenges. Popul Bull 59(2) (Washington, DC: Population Reference Bureau)Google Scholar
  33. 33.
    Wohlfahrt J, Melbye M (2001) Age at any birth is associated with breast cancer risk. Epidemiology 12:68–73PubMedCrossRefGoogle Scholar
  34. 34.
    Neupert RF (1992) Mongolia: recent demographic trends and implications. Asia Pac Popul J 7:3–24PubMedGoogle Scholar
  35. 35.
    Sedgh G, Henshaw SK, Singh S, Bankole A, Drescher J (2007) Legal abortion worldwide: incidence and recent trends. Perspect Sex Reprod Health 39:216–225PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media B.V. (outside the USA)  2012

Authors and Affiliations

  • Rebecca Troisi
    • 1
    • 9
  • Dalkhjav Altantsetseg
    • 2
  • Ganmaa Davaasambuu
    • 3
  • Janet Rich-Edwards
    • 4
  • Dambadarjaa Davaalkham
    • 5
  • Steinar Tretli
    • 6
  • Robert N. Hoover
    • 1
  • A. Lindsay Frazier
    • 7
    • 8
  1. 1.Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human ServicesBethesdaUSA
  2. 2.Mongolian National Oncology CenterUlaanbaatorMongolia
  3. 3.Department of NutritionHarvard School of Public HealthBostonUSA
  4. 4.Connors Center for Women’s Health and Gender BiologyBrigham and Women’s HospitalBostonUSA
  5. 5.Health Sciences University of MongoliaUlaanbaatorMongolia
  6. 6.Cancer Registry of NorwayOsloNorway
  7. 7.Department of PediatricsHarvard Medical SchoolBostonUSA
  8. 8.Dana Farber Cancer InstituteBostonUSA
  9. 9.Dartmouth-Hitchcock Medical CenterLebanonUSA

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