A Hierarchical Age-Period-Cohort Analysis of Breast Cancer Mortality and Disability Adjusted Life Years (1990-2015) Attributable to Modified Risk Factors among Chinese Women.

Sumaira Mubarik,Fang Shi,Saima Shakil Malik,Fang Wang,Chuanhua Yu,Yafeng Wang,Nawsherwan Nawsherwan

doi:10.3390/ijerph17041367

Abstract

Limited studies quantified the age, period, and cohort effects attributable to different risk factors on mortality rates (MRs) and disability-adjusted life years (DALYs) due to breast cancer among Chinese women. We used data from the Global Burden of Disease Study (GBD) in 2017. Mixed-effect and hierarchical age–period–cohort (HAPC) models were used to assess explicit and implicit fluctuations in MRs and DALYs attributable to different breast cancer associated risk factors. As the only risk factor, high body mass index (HBMI) showed continuously increasing trends in MRs and DALYs across ages, periods, and cohorts. Age, recent periods (2010–2015), and risk factor HBMI showed significant positive effect on MRs and DALYs (p < 0.05). Moreover, we reported significant interaction effects of older age and period in recent years in addition to the interplay of older age and risk factor HBMI on MRs and DALYs. Increased age and obesity contribute to substantially raised breast cancer MRs and DALYs in China and around the globe. These discoveries shed light on protective health policies and provision of healthy lifestyle for improving the subsequent breast cancer morbidity and mortality for China, as well as other related Asian regions that are presently facing the same public health challenges.

Highlights

Breast cancer is the most commonly diagnosed cancer or disease among women all over the world and linked with considerable years of life lost, leading to increased cancer-related mortality and morbidity [1,2,3]
As the aim of the study was quantifying the variations in breast cancer mortality rates (MRs) and disability-adjusted life years (DALYs) across age, periods, cohorts, and interactions with different risk factors, an individual model was constructed for both outcomes for the Chinese female population
To measure the potential changes related to risk factors, we described the breast cancer outcomes (MRs and DALYs) stratified by different risks for age, period, and cohort

Summary

Introduction

Breast cancer is the most commonly diagnosed cancer or disease among women all over the world and linked with considerable years of life lost, leading to increased cancer-related mortality and morbidity [1,2,3]. Breast cancer has multifactorial etiology and involves a complex interplay between genetic, epigenetic, and adjustable lifestyle or environmental factors [4]. Considering lifestyle factors, obesity, extravagant alcohol consumption, physical inactivity, and insufficient diet protrude as adaptable risk factors, which, if avoided, could help in breast cancer management and prevention [5]. It is still unknown whether researchers explored the burden of mortality rates from breast cancer due to all these adaptable risk factors among the individuals of the same population. Age is one of the most imperative breast cancer incidence-related risk factors. The breast cancer incidence varies drastically with race and ethnicity, even among young women.

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