Abstract

Background: Data on burden and changing trends of breast cancer are of value for policymaking. We aimed to determine the pattern of breast cancer incidence, mortality, and disability-adjusted life-years (DALYs), as well as temporal trends, from 1990 to 2017.Methods: We collected detailed information on breast cancer between 1990 and 2017 using the results of the Global Burden of Disease study. The number of incident cases, deaths, and DALYs attributable to breast cancer are reported as well as age-standardized rates. Estimated annual percentage changes (EAPCs) in age-standardized rates were calculated to quantify the temporal trends. Moreover, the attributable burden to breast cancer risk factors was also estimated.Results: There were 1,960,682 incident cases and 611,625 deaths of breast cancer globally in 2017, contributing to 17,708,600 DALYs. The age-standardized incidence rates (ASIRs) increased between 1990 and 2017, while the age-standardized mortality rates and DALY rates decreased. The corresponding EAPCs were 0.41, −0.62, and −0.56, respectively. These trends were heterogeneous across regions and countries. The increase in the ASIRs was more prominent in countries with a low sociodemographic index. The percentages of breast cancer deaths due to alcohol use and tobacco were decreasing, while deaths due to high body mass index and high fasting plasma glucose were increasing.Conclusion: Breast cancer remained a major public health concern globally. The trends of incidence, mortality, and DALYs were heterogeneous across regions and countries, suggesting that the allocation of appropriate health care resources for breast cancer should be considered at the national scale and even at the subnational scale.

Highlights

  • In women, breast cancer is the most frequently diagnosed cancer and the leading cause of cancer-associated death worldwide [1]

  • The number of breast cancer cases increased by 123.14% (95% uncertainty intervals (UIs): 104.06–135.62%) from 1990 to 2017, and the estimated annual percentage change (EAPC) of age-standardized incident rates (ASIRs) was 0.41

  • Breast cancer led to a 74.96% (95% UI: 57.34–87.02%) increase in deaths in 2017 compared to 1990, with the age-standardized mortality rates (ASMRs) decreasing from 8.66 (95% UI: 8.28–9.37) in 1990 to 7.65 (95% UI: 7.37–8.01) per 100,000 persons in 2017 (EAPC: −0.62; 95% confidential interval (CI): −0.68 to −0.55)

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Summary

Introduction

Breast cancer is the most frequently diagnosed cancer and the leading cause of cancer-associated death worldwide [1]. Breast cancer is considered a curable disease, while metastatic breast cancer is associated with poor outcomes. Despite the rapid development of diagnostic and therapeutic methods for breast cancer, different regions and individual countries develop at different speeds, leading to the substantial diversity of disease burden [3]. Nonhereditary causes of breast cancer predominate but are still unclear; these causes include early menarche, late age at menopause, exogenous hormone intake, alcohol consumption, smoking, and obesity, all of which are commonly reported as risk factors [1]. Data on burden and changing trends of breast cancer are of value for policymaking. We aimed to determine the pattern of breast cancer incidence, mortality, and disability-adjusted life-years (DALYs), as well as temporal trends, from 1990 to 2017

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