Advertisement

Breast Cancer Epidemiology

  • Alicia Brunßen
  • Joachim Hübner
  • Alexander KatalinicEmail author
  • Maria R. Noftz
  • Annika Waldmann
Chapter

Abstract

Breast cancer is the most frequent cancer in women and still one of the most common causes of cancer-related deaths in women worldwide. In 2012, 1.7 million cases of breast cancer were estimated by the WHO, with a different distribution in the burden of disease. In this chapter, relevant aspects of the epidemiology of breast cancer with an international perspective, including incidence, mortality and prevalence rates, are presented. Additionally, different aspects on modifiable and non-modifiable risk factors of breast cancer and their diverse impact in women are introduced, such as age, genetic predispositions, anthropometric measures, hormones, breast density, ionizing radiation and diet/lifestyle. In regard to prevention of breast cancer, women can perceive different kinds of primary and secondary prevention measures. For secondary prevention, mammography screening is offered in many countries to women over 50 years. This chapter includes a summary on the latest update on mammography screening and other prevention possibilities. As breast cancer is a complex and heterogeneous disease, different prognostic factors are of great importance to predict on outcome and overall survival in women with breast cancer. The variety of prognostic factors and survival rates are also addressed in this book chapter.

Keywords

Breast cancer Epidemiology Incidence Prevalence Mortality Survival Risk factors Prognosis Prevention 

References

  1. 1.
    World Health Organization, International Agency for Research on Cancer. GLOBOCAN 2012: Estimated Cancer Incidence, Mortality and Prevalence Worldwide in 2012. 2012 [December 9, 2012]; Available from: http://globocan.iarc.fr/.
  2. 2.
    Stewart EW, Wild CP. World cancer report 2014. Lyon: International Agency for Research on Cancer; 2014.Google Scholar
  3. 3.
    Howlader N, Noone AM, Krapcho M, Garshell J, Miller D, Altekruse SF, et al. SEER cancer statistics review 1975–2012 Bethesda, MD: National Cancer Institute; 2015 [updated based on November 2014 SEER data submission, posted to the SEER web site, April 2015, January 6, 2016]; Available from: http://seer.cancer.gov/csr/1975_2012/.
  4. 4.
    Youlden DR, Cramb SM, Yip CH, Baade PD. Incidence and mortality of female breast cancer in the Asia-Pacific region. Cancer biol Med. 2014;11(2):101–15 Epub 2014/07/11.PubMedPubMedCentralGoogle Scholar
  5. 5.
    Song Q-K, Li J, Huang R, Fan J-H, Zheng R-S, Zhang B-N, et al. Age of diagnosis of breast cancer in China: almost 10 years earlier than in the United States and the European Union. Asian Pac J Cancer Prev. 2015;15(22):10021.Google Scholar
  6. 6.
    Fentiman IS, Fourquet A, Hortobagyi GN. Male breast cancer. Lancet. 2006;367(9510):595–604 Epub 2006/02/21.CrossRefPubMedGoogle Scholar
  7. 7.
    Robert Koch-Institute. Cancer in Germany 2009/2010 [Krebs in Deutschland 2009/2010]. 9th ed. Berlin 2013.Google Scholar
  8. 8.
    Cancer Research UK 2014. Breast cancer in men. 2014 [updated July 30, 2014, December 16, 2015]; Available from: http://www.cancerresearchuk.org/about-cancer/type/rare-cancers/rare-cancers-name/breast-cancer-in-men.
  9. 9.
    Association of the Nordic Cancer Registries (NORDCAN). NORDCAN, Cancer stat fact sheets. 2015 [updated December 11, 2015, December 16, 2015]; Available from: http://www-dep.iarc.fr/NORDCAN/english/StatsFact.asp?cancer=200&country=0.
  10. 10.
    American Cancer Society. What are the key statistics about breast cancer? 2015 [updated October 6, 2015 December 16, 2015]; Available from: http://www.cancer.org/cancer/breastcancer/detailedguide/breast-cancer-key-statistics.
  11. 11.
  12. 12.
    World, Health, Organization. Global Health Observatory, Visualizations, Causes of death - Ten leading causes of death. 2012 [December 10, 2015]; Available from: http://www.who.int/gho/mortality_burden_disease/causes_death/top_10/en/.
  13. 13.
    Cancer Research UK 2013. Cancer mortality by age. 2013 [updated December 4, 2013 January 6, 2016]; Available from: http://www.cancerresearchuk.org/content/cancer-mortality-by-age#heading-Two.
  14. 14.
    Singletary SE. Rating the risk factors for breast cancer. Ann Surg. 2003;237(4):474–82 Epub 2003/04/05.PubMedPubMedCentralGoogle Scholar
  15. 15.
    Pharoah PD, Day NE, Duffy S, Easton DF, Ponder BA. Family history and the risk of breast cancer: a systematic review and meta-analysis. Int J Cancer J Int du Cancer. 1997;71(5):800–9 Epub 1997/05/29.CrossRefGoogle Scholar
  16. 16.
    Collaborative Group on Hormonal Factors in Breast Cancer. Familial breast cancer: collaborative reanalysis of individual data from 52 epidemiological studies including 58,209 women with breast cancer and 101,986 women without the disease. Lancet. 2001;358(9291):1389–99 Epub 2001/11/14.CrossRefGoogle Scholar
  17. 17.
    Slattery ML, Kerber RA. A comprehensive evaluation of family history and breast cancer risk. The Utah Population Database. JAMA. 1993;270(13):1563–8 Epub 1993/10/06.CrossRefPubMedGoogle Scholar
  18. 18.
    Dossus L, Benusiglio PR. Lobular breast cancer: incidence and genetic and non-genetic risk factors. Breast Cancer Res: BCR. 2015;17:37 Epub 2015/04/08.CrossRefPubMedPubMedCentralGoogle Scholar
  19. 19.
    Lalloo F, Evans DG. Familial breast cancer. Clin Genet. 2012;82(2):105–14 Epub 2012/02/24.CrossRefPubMedGoogle Scholar
  20. 20.
    Chompret A, Brugieres L, Ronsin M, Gardes M, Dessarps-Freichey F, Abel A, et al. P53 germline mutations in childhood cancers and cancer risk for carrier individuals. Br J Cancer. 2000;82(12):1932–7 Epub 2000/06/23.CrossRefPubMedPubMedCentralGoogle Scholar
  21. 21.
    Couch FJ, Nathanson KL, Offit K. Two decades after BRCA: setting paradigms in personalized cancer care and prevention. Science. 2014;343(6178):1466–70 Epub 2014/03/29.CrossRefPubMedPubMedCentralGoogle Scholar
  22. 22.
    Easton DF, Pooley KA, Dunning AM, Pharoah PD, Thompson D, Ballinger DG, et al. Genome-wide association study identifies novel breast cancer susceptibility loci. Nature. 2007;447(7148):1087–93 Epub 2007/05/29.CrossRefPubMedPubMedCentralGoogle Scholar
  23. 23.
    Stone J, Thompson DJ, Dos Santos Silva I, Scott C, Tamimi RM, Lindstrom S, et al. Novel associations between common breast cancer susceptibility variants and risk-predicting mammographic density measures. Cancer Res. 2015;75(12):2457–67 Epub 2015/04/12.CrossRefPubMedPubMedCentralGoogle Scholar
  24. 24.
    Zhang B, Shu XO, Delahanty RJ, Zeng C, Michailidou K, Bolla MK, et al. Height and breast cancer risk: evidence from prospective studies and mendelian randomization. J Natl Cancer Inst. 2015;107(11). Epub 2015/08/25.Google Scholar
  25. 25.
    van den Brandt PA, Spiegelman D, Yaun SS, Adami HO, Beeson L, Folsom AR, et al. Pooled analysis of prospective cohort studies on height, weight, and breast cancer risk. Am J Epidemiol. 2000;152(6):514–27 Epub 2000/09/21.CrossRefPubMedGoogle Scholar
  26. 26.
    McTiernan A. Behavioral risk factors in breast cancer: can risk be modified? Oncologist. 2003;8(4):326–34 Epub 2003/08/05.CrossRefPubMedGoogle Scholar
  27. 27.
    Collaborative Group on Hormonal Factors in Breast Cancer. Menarche, menopause, and breast cancer risk: individual participant meta-analysis, including 118 964 women with breast cancer from 117 epidemiological studies. Lancet Oncol. 2012;13(11):1141–51 Epub 2012/10/23.CrossRefPubMedCentralGoogle Scholar
  28. 28.
    National Breast and Ovarian Cancer Centre (NBOCC). Breast cancer risk factors: a review of the evidence. 2009.Google Scholar
  29. 29.
    Collaborative Group on Hormonal Factors in Breast Cancer. Breast cancer and breastfeeding: collaborative reanalysis of individual data from 47 epidemiological studies in 30 countries, including 50302 women with breast cancer and 96973 women without the disease. Lancet. 2002;360(9328):187–95 Epub 2002/07/23.CrossRefGoogle Scholar
  30. 30.
    Renehan AG, Zwahlen M, Minder C, O’Dwyer ST, Shalet SM, Egger M. Insulin-like growth factor (IGF)-I, IGF binding protein-3, and cancer risk: systematic review and meta-regression analysis. Lancet. 2004;363(9418):1346–53 Epub 2004/04/28.CrossRefPubMedGoogle Scholar
  31. 31.
    Gierisch JM, Coeytaux RR, Urrutia RP, Havrilesky LJ, Moorman PG, Lowery WJ, et al. Oral contraceptive use and risk of breast, cervical, colorectal, and endometrial cancers: a systematic review. Cancer Epidemiol Biomark Prev. 2013;22(11):1931–43 Epub 2013/09/10, A Publication of the American Association for Cancer Research, Cosponsored by the American Society of Preventive Oncology.CrossRefGoogle Scholar
  32. 32.
    Narod SA. Hormone replacement therapy and the risk of breast cancer. Nat Rev Clin Oncol. 2011;8(11):669–76 Epub 2011/08/03.CrossRefPubMedGoogle Scholar
  33. 33.
    Friis S, Kesminiene A, Espina C, Auvinen A, Straif K, Schuz J. European code against cancer 4th edition: medical exposures, including hormone therapy, and cancer. Cancer Epidemiol. 2015;39(Suppl 1):S107–19 Epub 2015/09/24.CrossRefPubMedGoogle Scholar
  34. 34.
    McCormack VA, dos Santos Silva I. Breast density and parenchymal patterns as markers of breast cancer risk: a meta-analysis. Cancer Epidemiol Biomark Prev. 2006;15(6):1159–69 Epub 2006/06/16, A Publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology.CrossRefGoogle Scholar
  35. 35.
    Dyrstad SW, Yan Y, Fowler AM, Colditz GA. Breast cancer risk associated with benign breast disease: systematic review and meta-analysis. Breast Cancer Res Treat. 2015;149(3):569–75 Epub 2015/02/01.CrossRefPubMedGoogle Scholar
  36. 36.
    Seitz HK, Pelucchi C, Bagnardi V, La Vecchia C. Epidemiology and pathophysiology of alcohol and breast cancer: Update 2012. Alcohol and alcoholism (Oxford, Oxfordshire). 2012;47(3):204–12. Epub 2012/03/31.Google Scholar
  37. 37.
    Aune D, Chan DS, Vieira AR, Rosenblatt DA, Vieira R, Greenwood DC, et al. Fruits, vegetables and breast cancer risk: a systematic review and meta-analysis of prospective studies. Breast Cancer Res Treat. 2012;134(2):479–93 Epub 2012/06/19.CrossRefPubMedGoogle Scholar
  38. 38.
    Zheng JS, Hu XJ, Zhao YM, Yang J, Li D. Intake of fish and marine n-3 polyunsaturated fatty acids and risk of breast cancer: meta-analysis of data from 21 independent prospective cohort studies. BMJ. 2013;346:f3706 Epub 2013/07/03.CrossRefPubMedGoogle Scholar
  39. 39.
    Hu F, Wang Yi B, Zhang W, Liang J, Lin C, Li D, et al. Carotenoids and breast cancer risk: a meta-analysis and meta-regression. Breast Cancer Res Treat. 2012;131(1):239–53 Epub 2011/09/09.CrossRefPubMedGoogle Scholar
  40. 40.
    Zhang YF, Shi WW, Gao HF, Zhou L, Hou AJ, Zhou YH. Folate intake and the risk of breast cancer: a dose-response meta-analysis of prospective studies. PloS One. 2014;9(6):e100044. Epub 2014/06/17.Google Scholar
  41. 41.
    Monninkhof EM, Elias SG, Vlems FA, van der Tweel I, Schuit AJ, Voskuil DW, et al. Physical activity and breast cancer: a systematic review. Epidemiology. 2007;18(1):137–57 Epub 2006/11/30.CrossRefPubMedGoogle Scholar
  42. 42.
    Colditz GA, Bohlke K. Priorities for the primary prevention of breast cancer. CA Cancer J Clin. 2014;64(3):186–94 Epub 2014/03/22.CrossRefPubMedGoogle Scholar
  43. 43.
    Hartmann LC, Schaid DJ, Woods JE, Crotty TP, Myers JL, Arnold PG, et al. Efficacy of bilateral prophylactic mastectomy in women with a family history of breast cancer. New Engl J Med. 1999;340(2):77–84 Epub 1999/01/14.CrossRefPubMedGoogle Scholar
  44. 44.
    Howell A, Anderson AS, Clarke RB, Duffy SW, Evans DG, Garcia-Closas M, et al. Risk determination and prevention of breast cancer. Breast cancer research: BCR. 2014;16(5):446. Epub 2014/12/04.Google Scholar
  45. 45.
    Fisher B, Costantino JP, Wickerham DL, Redmond CK, Kavanah M, Cronin WM, et al. Tamoxifen for prevention of breast cancer: report of the national surgical adjuvant breast and bowel project P-1 study. J Natl Cancer Inst. 1998;90(18):1371–88 Epub 1998/09/25.CrossRefPubMedGoogle Scholar
  46. 46.
    Visvanathan K, Hurley P, Bantug E, Brown P, Col NF, Cuzick J, et al. Use of pharmacologic interventions for breast cancer risk reduction: American Society of Clinical Oncology clinical practice guideline. J Clin Oncol. 2013;31(23):2942–62 Epub 2013/07/10, Official journal of the American Society of Clinical Oncology.CrossRefPubMedGoogle Scholar
  47. 47.
    Domchek SM, Friebel TM, Singer CF, Evans DG, Lynch HT, Isaacs C, et al. Association of risk-reducing surgery in BRCA1 or BRCA2 mutation carriers with cancer risk and mortality. JAMA. 2010;304(9):967–75 Epub 2010/09/03.CrossRefPubMedPubMedCentralGoogle Scholar
  48. 48.
    Rebbeck TR, Friebel T, Lynch HT, Neuhausen SL, van ‘t Veer L, Garber JE, et al. Bilateral prophylactic mastectomy reduces breast cancer risk in BRCA1 and BRCA2 mutation carriers: the PROSE Study Group. J Clin Oncol. 2004;22(6):1055–62 Epub 2004/02/26, Official journal of the American Society of Clinical Oncology.CrossRefPubMedGoogle Scholar
  49. 49.
    Claus EB, Risch N, Thompson WD. The calculation of breast cancer risk for women with a first degree family history of ovarian cancer. Breast Cancer Res Treat. 1993;28(2):115–20 Epub 1993/11/01.CrossRefPubMedGoogle Scholar
  50. 50.
    Gail MH, Brinton LA, Byar DP, Corle DK, Green SB, Schairer C, et al. Projecting individualized probabilities of developing breast cancer for white females who are being examined annually. J Natl Cancer Inst. 1989;81(24):1879–86 Epub 1989/12/20.CrossRefPubMedGoogle Scholar
  51. 51.
    Tyrer J, Duffy SW, Cuzick J. A breast cancer prediction model incorporating familial and personal risk factors. Stat Med. 2004;23(7):1111–30 Epub 2004/04/02.CrossRefPubMedGoogle Scholar
  52. 52.
    Lauby-Secretan B, Scoccianti C, Loomis D, Benbrahim-Tallaa L, Bouvard V, Bianchini F, et al. Breast-cancer screening–viewpoint of the IARC Working Group. New Engl J Med. 2015;372(24):2353–8 Epub 2015/06/04.CrossRefPubMedGoogle Scholar
  53. 53.
    U.S. Preventive Task Force. Screening for breast cancer: U.S. Preventive Services Task Force recommendation statement. Annals of internal medicine. 2009;151(10):716–26, W-236. Epub 2009/11/19.Google Scholar
  54. 54.
    Kosters JP, Gotzsche PC. Regular self-examination or clinical examination for early detection of breast cancer. The Cochrane database of systematic reviews. 2003(2):CD003373. Epub 2003/06/14.Google Scholar
  55. 55.
    Weiss NS. Breast cancer mortality in relation to clinical breast examination and breast self-examination. Breast J. 2003;9(Suppl 2):S86–9 Epub 2003/04/26.CrossRefPubMedGoogle Scholar
  56. 56.
    Gotzsche PC, Jorgensen KJ. Screening for breast cancer with mammography. The Cochrane database of systematic reviews. 2013;6:CD001877. Epub 2013/06/06.Google Scholar
  57. 57.
    Independent UK. Panel on breast cancer screening. The benefits and harms of breast cancer screening: an independent review. Lancet. 2012;380(9855):1778–86 Epub 2012/11/03.CrossRefGoogle Scholar
  58. 58.
    The Hague, Netherlands HCot. Health Council of the Netherlands. Population screening for breast cancer: expectations and developments. 2014;publication no. 2014/01.Google Scholar
  59. 59.
    Fügemann H, Kääb-Sanyal V. Mammographie-Screening: Nutzen-Schaden-Abwägung im internationalen Vergleich. Deutsches Ärzteblatt. 2016;113(3).Google Scholar
  60. 60.
    Gesundheitswesen IfQuWi. Einladungsschreiben und Merkblatt zum Mammographie-Screening. Rapid Report. IQWiG-Berichte – Nr. 288. 2015.Google Scholar
  61. 61.
    Paci E, Group EW. Summary of the evidence of breast cancer service screening outcomes in Europe and first estimate of the benefit and harm balance sheet. J Med Screen. 2012;19(Suppl 1):5–13 Epub 2012/11/08.CrossRefGoogle Scholar
  62. 62.
    Allemani C, Weir HK, Carreira H, Harewood R, Spika D, Wang XS, et al. Global surveillance of cancer survival 1995-2009: analysis of individual data for 25,676,887 patients from 279 population-based registries in 67 countries (CONCORD-2). Lancet. 2015;385(9972):977–1010 Epub 2014/12/04.CrossRefPubMedGoogle Scholar
  63. 63.
    Clark GM. Prognostic and Predictive Factors for Breast Cancer. Breast Cancer (Tokyo, Japan). 1995;2(2):79–89. Epub 1995/10/31.Google Scholar
  64. 64.
    Senkus E, Kyriakides S, Ohno S, Penault-Llorca F, Poortmans P, Rutgers E, et al. Primary breast cancer: ESMO clinical practice guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2015;26(Suppl 5):v8–30 Epub 2015/09/01, Official journal of the European Society for Medical Oncology/ESMO.CrossRefPubMedGoogle Scholar
  65. 65.
    Ly ALS, Dillon D. Prognostic factors for patients with breast cancer: traditional and new. Surg Pathol. 2012;5:775–85.CrossRefGoogle Scholar
  66. 66.
    Blamey RW, Pinder SE, Ball GR, Ellis IO, Elston CW, Mitchell MJ, et al. Reading the prognosis of the individual with breast cancer. Eur J Cancer. 2007;43(10):1545–7 Epub 2007/02/27.CrossRefPubMedGoogle Scholar
  67. 67.
    Ravdin PM, Siminoff LA, Davis GJ, Mercer MB, Hewlett J, Gerson N, et al. Computer program to assist in making decisions about adjuvant therapy for women with early breast cancer. J Clin Oncol. 2001;19(4):980–91 Epub 2001/02/22, Official Journal of the American Society of Clinical Oncology.CrossRefPubMedGoogle Scholar
  68. 68.
    Soerjomataram I, Louwman MW, Ribot JG, Roukema JA, Coebergh JW. An overview of prognostic factors for long-term survivors of breast cancer. Breast Cancer Res Treat. 2008;107(3):309–30 Epub 2007/03/23.CrossRefPubMedGoogle Scholar
  69. 69.
    Holleczek B, Brenner H. Provision of breast cancer care and survival in Germany—results from a population-based high resolution study from Saarland. BMC Cancer. 2014;14:757 Epub 2014/10/12.CrossRefPubMedPubMedCentralGoogle Scholar
  70. 70.
    Allemani C, Sant M, Weir HK, Richardson LC, Baili P, Storm H, et al. Breast cancer survival in the US and Europe: a CONCORD high-resolution study. Int J Cancer J Int du Cancer. 2013;132(5):1170–81 Epub 2012/07/21.CrossRefGoogle Scholar
  71. 71.
    Subramaniam DS, Isaacs C. Utilizing prognostic and predictive factors in breast cancer. Curr Treat Options Oncol. 2005;6(2):147–59 Epub 2005/02/19.CrossRefPubMedGoogle Scholar
  72. 72.
    Elston CW, Ellis IO. Pathological prognostic factors in breast cancer. I. The value of histological grade in breast cancer: experience from a large study with long-term follow-up. Histopathology. 1991;19(5):403–10 Epub 1991/11/01.CrossRefPubMedGoogle Scholar
  73. 73.
    Bloom HJ, Richardson WW. Histological grading and prognosis in breast cancer; a study of 1409 cases of which 359 have been followed for 15 years. Br J Cancer. 1957;11(3):359–77 Epub 1957/09/01.CrossRefPubMedPubMedCentralGoogle Scholar
  74. 74.
    Kos Z, Dabbs DJ. Biomarker assessment and molecular testing for prognostication in breast cancer. Histopathology. 2016;68(1):70–85 Epub 2016/01/16.CrossRefPubMedGoogle Scholar
  75. 75.
    Tinnemans JG, Beex LV, Wobbes T, Sluis RF, Raemaekers JM, Benraad T. Steroid-hormone receptors in nonpalpable and more advanced stages of breast cancer. A contribution to the biology and natural history of carcinoma of the female breast. Cancer. 1990;66(6):1165–7 Epub 1990/09/15.CrossRefPubMedGoogle Scholar
  76. 76.
    Fisher B, Redmond C, Fisher ER, Caplan R. Relative worth of estrogen or progesterone receptor and pathologic characteristics of differentiation as indicators of prognosis in node negative breast cancer patients: findings from National Surgical Adjuvant Breast and Bowel Project Protocol B-06. J Clin Oncol. 1988;6(7):1076–87 Epub 1988/07/01, Official Journal of the American Society of Clinical Oncology.CrossRefPubMedGoogle Scholar
  77. 77.
    Weigel MT, Dowsett M. Current and emerging biomarkers in breast cancer: prognosis and prediction. Endocr Relat Cancer. 2010;17(4):R245–62 Epub 2010/07/22.CrossRefPubMedGoogle Scholar
  78. 78.
    Reed W, Hannisdal E, Boehler PJ, Gundersen S, Host H, Marthin J. The prognostic value of p53 and c-erb B-2 immunostaining is overrated for patients with lymph node negative breast carcinoma: a multivariate analysis of prognostic factors in 613 patients with a follow-up of 14–30 years. Cancer. 2000;88(4):804–13 Epub 2000/02/19.CrossRefPubMedGoogle Scholar
  79. 79.
    Menard S, Balsari A, Casalini P, Tagliabue E, Campiglio M, Bufalino R, et al. HER-2-positive breast carcinomas as a particular subset with peculiar clinical behaviors. Clin Cancer Res. 2002;8(2):520–5 Epub 2002/02/13, An official journal of the American Association for Cancer Research.PubMedGoogle Scholar
  80. 80.
    Toss A, Cristofanilli M. Molecular characterization and targeted therapeutic approaches in breast cancer. Breast Cancer Res: BCR. 2015;17:60 Epub 2015/04/24.CrossRefPubMedPubMedCentralGoogle Scholar
  81. 81.
    Coates AS, Winer EP, Goldhirsch A, Gelber RD, Gnant M, Piccart-Gebhart M, et al. Tailoring therapies-improving the management of early breast cancer: St Gallen International Expert Consensus on the Primary Therapy of Early Breast Cancer 2015. Ann Oncol. 2015;26(8):1533–46 Epub 2015/05/06, Official journal of the European Society for Medical Oncology/ESMO.CrossRefPubMedPubMedCentralGoogle Scholar
  82. 82.
    Hankinson S, Tamini R, Hunter D. Breast cancer. In: Adami HO, Hunter D, Trichopoulos D, editors. Textbook of cancer epidemiology. 2nd ed 2008.Google Scholar

Copyright information

© Springer International Publishing Switzerland 2016

Authors and Affiliations

  • Alicia Brunßen
    • 1
  • Joachim Hübner
    • 2
  • Alexander Katalinic
    • 2
    Email author
  • Maria R. Noftz
    • 2
  • Annika Waldmann
    • 2
  1. 1.Department of SurgeryUniversity of Texas Health Science Center at San AntonioSan AntonioUSA
  2. 2.Institute for Social Medicine and EpidemiologyUniversity of LuebeckLuebeckGermany

Personalised recommendations