Abstract
Background: This study aimed to identify the role of human development index (HDI) in the incidence and mortality rates of breast cancer (BC) worldwide. Methods: Data on the age-standardized incidence and mortality rates of BC for 184 countries were obtained from the GLOBOCAN. Data about the HDI and other indices were obtained from the World Bank Report 2013. Linear regression model was used for assessment the effect of HDI on BC occurrence rates. Results: In 2012, BCs were estimated to have affected a total of 1,671,149 individuals (crude rate: 47.8 per 100,000 individuals), and caused 521,907 deaths worldwide (crude rate: 14.7 per 100,000 individuals). Nearly half of total female BC cases (46.3%) with the highest risk of incidence (age-standardized Rate (ASR): 128 per 100,000) had occurred in very high HDI regions. The most proportion of the mortality burden was in low HDI and medium HDI areas. Linear regression analyses showed a direct significant correlation between the incidence of BC and HDI at the global level (B = 104.5, P < 0.001). The mortality rate of BC was not significantly associated with HDI (B = 3.26, P = 0.160). Conclusion: Our study showed that the burden of female BC is enormous in very high HDI and low HID regions. Targeted interventions have the ability to reduce this number significantly through resource-dependent interventions. Moreover, further reductions in mortality could be brought about by increasing access to curative treatment for patients with BC.
Highlights
Cancer, already the leading cause of death in many high-income countries, is set to become a major cause of morbidity and mortality in the rest of the world irrespective of level of resources [1]
Our study showed that the burden of female breast cancer (BC) is enormous in very high human development index (HDI) and low HID regions
HDI has several main components that include: life expectancy at birth, mean years of schooling, and gross national income (GNI) per capita; and some ancillary indexes including total fertility rate, percent of urbanization, and age standardized obesity in adults
Summary
Already the leading cause of death in many high-income countries, is set to become a major cause of morbidity and mortality in the rest of the world irrespective of level of resources [1]. Despite the high incidence in developed countries, BC mortality imposes the greater burden in developing world due to urbanizations, westernization, and increased life expectancy [6] [7], as well as unequal distribution of resources such as access to medical care, physician distribution; and psychological factors such as stress, or lack of social support [8]-[11] as important related factors have been reported. Half of total female BC cases (46.3%) with the highest risk of incidence (age-standardized Rate (ASR): 128 per 100,000) had occurred in very high HDI regions.
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