Evidence map›Paper›PMID 40597026›Full record

ArticleBMC cancer2025

Breast cancer mortality in Romania: trends, regional and rural-urban inequalities, and policy implications.

John W Carew, Silviu Calin Radulescu, Li Zhang, Carmen Ungurean, Cristian Calomfirescu, Florentina Furtunescu, Amr S Soliman

Abstract read
In one paragraph

Article in BMC cancer, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

John W Carew *University of Vermont, Burlington, VT, 05405, USA.
Silviu Calin Radulescu *Institutul Național de Sănătate Publică, Bucharest, Romania.
Li Zhang *The City University of New York School of Medicine, New York, NY, 10031, USA.
Carmen UngureanInstitutul Național de Sănătate Publică, Bucharest, Romania.
Cristian CalomfirescuInstitutul Național de Sănătate Publică, Bucharest, Romania.
Florentina FurtunescuInstitutul Național de Sănătate Publică, Bucharest, Romania.
Amr S SolimanThe City University of New York School of Medicine, New York, NY, 10031, USA. asoliman@med.cuny.edu.

Funding

Research Center in Minority Institutions (RCMI) at City CollegeU54MD017979 · NIMHD · CITY COLLEGE OF NEW YORK · PI M. Felice Marina GHILARDI · 2024 to 2026
$15.9M
Cancer Epidemiology Education in Special Populations Program-15R25CA112383 · NCI · UNIVERSITY OF NEBRASKA MEDICAL CENTER · PI Amr Soliman · 2006 to 2026
$6.1M
NCI NIH HHS R25CA112383NIMHD NIH HHS U54 MD017979
6 · The paper itself

Abstract

backgroundRomania has the third highest preventable mortality rate in the European Union that is more than double the average rate in the European Union in 2018. Breast cancer (BC) is a significant driver of global preventable mortality but a few studies from Romania have quantified the degree to which BC influences mortality and morbidity. This study aimed to determine differences in BC mortality between Romania and the European Union. The study also examined urban/rural BC mortality across the eight regions of Romania.

methodsAge-standardized BC mortality rates among women were calculated by urban/rural places of residence and by subnational region for 2000-2020, using data provided by the Romanian National Center for Statistics in Public Health, National Institute of Public Health. Age-standardized all-cause, all-cancer, and BC mortality rates were explored for Romania and the European Union for 2000-2017, using data obtained from Eurostat. Urban and rural age-standardized BC mortality rates among women were compared across regions of Romania to national and European rates to examine differences in BC mortality across the country and between urban and rural areas. Joinpoint Trend Analysis was employed to further analyze patterns in mortality rates.

resultsAge-standardized national BC mortality rate in Romania decreased from 39.60/100,000 women in 2000 to 38.35/100,000 women in 2020, however rates increased in several regions of the country. While BC mortality rates decreased more in urban areas (by 11.1%) than in rural areas (by 1.6%), urban areas still had a higher BC mortality (46.24/100,000 women in 2020) than rural areas (29.37/100,000 women in 2020) throughout the study period.

conclusionThe higher BC mortality in Romania compared to other countries in the European countries, the higher mortality rates in urban than rural areas, and the regional variation in mortality rates call for future studies to investigate the possible health care system and care seeking behaviors and the environmental determinants that may have contributed to observed mortality profile. Improving the quality of incidence data in the country through efficient cancer registries could also lead to a better understanding of the variation in mortality rates, which is the premise for more targeted health policies.

Indexed as

Breast NeoplasmsHealth PolicyRural PopulationUrban PopulationAdultAgedFemaleHumansMiddle AgedMortalityRomaniaSocioeconomic FactorsBreast cancerMortalityRegional inequalitiesRomaniaUrban–rural inequalities

Identifiers

PMID40597026
PMCPMC12211744

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LicenceCC BY-NC-ND
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.