The comparison is more nuanced than a simple yes or no answer, with significant variation across European countries.
Global patterns: According to GLOBOCAN 2020 data, Northern America had an age-standardized incidence rate of 89.4 per 100,000, while Western Europe had 90.7 per 100,000—slightly higher than North America [1]. However, incidence rates over 80 per 100,000 females were observed in Australia/New Zealand, Western Europe, Northern America, and Northern Europe, while rates below 40 per 100,000 were found in Central America, Eastern and Middle Africa, and South-Central Asia [2].
European variation: Within Europe, Belgium had the highest incidence at 113 cases per 100,000, followed by Luxembourg at 109 cases per 100,000 [3]. European rates varied over threefold, from 113.2 per 100,000 in Belgium to lower rates in developing countries, with highly developed countries generally having much higher incidence rates than the global average of 47.8 per 100,000 [4]. Southern and Eastern European countries generally have lower rates than Northern and Western European countries.
Contributing factors: The higher rates in developed countries may reflect screening practices, reproductive patterns (later childbearing, fewer children, less breastfeeding), lifestyle factors, and obesity rates.
Regulatory differences: The EU has banned or restricted over 1,300 chemicals in cosmetics, while the US has banned only 11 [5]. EU regulations call for minimization of human exposure to endocrine-disrupting chemicals and their identification as substances of very high concern, with a ban on their use in pesticides, while US screening programs focus exclusively on estrogenic compounds and regulation is strictly risk-based [6]. The EU recognized endocrine-disrupting chemicals in legislation since the late 1990s through policies including REACH (2007) and regulations on plant protection products, biocides, and cosmetics [7].
Bottom line: Overall breast cancer incidence rates are similar between the US and Western/Northern Europe, with some European countries showing higher rates. Southern and Eastern European countries generally have lower rates. The EU’s more restrictive chemical regulations may contribute to reduced population-level exposures to endocrine-disrupting compounds compared to the US.
References
[1] Ahmad, Faisal, Abir Nahar Shafiulla, Nusrat Sultana, Jasmine Ferdousi, and Saleh Ahmed. “Breast Cancer: Global Patterns of Incidence, Mortality, and Trends.” Journal of Clinical Oncology 41, no. 16_suppl (June 2023): 10528.
[2] Arnold, Melina, Eileen Morgan, Harriet Rumgay, Ariana Macia, Deependra Singh, Mathieu Laversanne, Joannie Vignat, Jerome R. Gralow, Freddie Bray, and Isabelle Soerjomataram. “Current and Future Burden of Breast Cancer: Global Statistics for 2020 and 2040.” The Breast 66 (December 2022): 15–23.
[3] “Breast Cancer.” The Cancer Atlas. Accessed November 2024.
[4] Lei, Siwei, Yumeng Zheng, Ruiying Zhang, Si Wang, Ruijia Chen, Kaiyong Sun, Qin Zeng, Jinlin Zhou, and Ping Wei. “Global Patterns of Breast Cancer Incidence and Mortality: A Population-Based Cancer Registry Data Analysis from 2000 to 2020.” Cancer Communications 41, no. 11 (November 2021): 1183–1194.
[5] “EU vs US: Why Chemical Regulations Are So Different.” Radiant Health and Wellness. Accessed November 2024.
[6] Trasande, Leonardo, R. Thomas Zoeller, Ulla Hass, Andreas Kortenkamp, Philippe Grandjean, John Peterson Myers, Joseph DiGangi, et al. “Endocrine-Disrupting Chemicals: Economic, Regulatory, and Policy Implications.” The Lancet Diabetes & Endocrinology 4, no. 8 (August 2016): 843–850.
[7] “Endocrine-Disrupting Chemicals in the European Union.” Endocrine Society. Last modified January 30, 2023.