Disease burden analysis and future trend prediction of female breast cancer in China and the worldwide from 1990 to 2021_Chinese Journal of Evidence-Based Medicine

Authors：

OUYANG Fei ,  SHI Lei

Department of Orthopaedics, The First Affiliated Hospital of Air Force Medical University, Xi'an 710032, P. R. China;

Corresponding author：

SHI Lei, Email: shilei_med@163.com

Keywords：

Breast cancer; Global burden of disease; Trend; Incidence; Mortality; Prevalence; Disability-adjusted life years

DOI：

10.7507/1672-2531.202409068

Video：

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Objective The aim of this study was to describe the trends in the burden of breast cancer in women of all ages in China from 1990 to 2021, compare it with the global burden of breast cancer in women, and predict the burden of disease in the next 15 years. Methods Based on the open data of the Global Burden of Disease (GBD) in 2021, the incidence, prevalence, mortality and disability-adjusted life years (DALYs) of breast cancer among women in China and the world were analyzed. Joinpoint was used to calculate annual percentage change (APC) and average annual percentage change (AAPC) to reflect the changing trend of disease burden. An autoregressive composite moving average (ARIMA) model was used to predict the disease burden of breast cancer in women from 2022 to 2036. Results From 1990 to 2021, the age-standardized incidence rate (ASIR) and age-standardized prevalence rate (ASPR) of female breast cancer in China showed an increasing trend, with an average annual increase of 2.400 7% and 2.334 8%, respectively, and the age-standardized mortality rate (ASMR) and age-standardized DALYs rate (ASDR) showed a decreasing trend. The average annual decline was 0.290 0% and 0.198 3%, respectively. Meanwhile, ASIR and ASPR of global female breast cancer also showed an increasing trend, with an average annual increase of 0.474 9% and 0.3445 2% respectively, while ASMR and ASDR showed a decreasing trend, with an average annual decrease of 0.425 2% and 0.321 8% respectively. Among them, there are differences in the impact of age on the burden of female breast cancer. The peak of ASIR and ASPR appears in the age group of 50 to 69 years old, and generally increases with the increase of age, and then decreases when reaching the peak. ASMR and ASDR increase with age. In the following 15 years, the prevalence of breast cancer in women in China and globally showed an increasing trend, while the mortality rate showed a decreasing trend. Conclusion From the analysis of the disease burden from 1990 to 2021, breast cancer has a huge harm to women, and the incidence of young and middle-aged women is high, the death rate of middle-aged and elderly women is high, and the disease time is long, which brings a heavy psychological and economic burden to patients and society. From the trend forecast for the next 15 years, the prevalence of breast cancer in women in China and the world will increase, while the mortality rate will decrease slightly, but the decrease is not large, which will bring huge public health challenges and put higher requirements on the prevention and control of the disease. To reduce the disease burden of breast cancer, comprehensive strategies for disease control are needed, including prevention of risk factors at the primary care level, screening of at-risk populations, and quality medical services.

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28.	Youlden DR, Cramb SM, Dunn NA, et al. The descriptive epidemiology of female breast cancer: an international comparison of screening, incidence, survival and mortality. Cancer Epidemiol, 2012, 36(3): 237-248.
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33.	GBD 2016 Causes of Death Collaborators. Global, regional, and national age-sex specific mortality for 264 causes of death, 1980-2016: a systematic analysis for the global burden of disease study 2016. Lancet, 2017, 390(10100): 1151-1210.

1. Sung H, Ferlay J, Siegel RL, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin, 2021, 71(3): 209-249.
2. Loibl S, Poortmans P, Morrow M, et al. Breast cancer. Lancet, 2021, 397(10286): 1750-1769.
3. GBD 2019 Cancer Risk Factors Collaborators. The global burden of cancer attributable to risk factors, 2010-19: a systematic analysis for the global burden of disease study 2019. Lancet, 2022, 400(10352): 563-591.
4. GBD 2021 Nervous System Disorders Collaborators. Global, regional, and national burden of disorders affecting the nervous system, 1990-2021: a systematic analysis for the global burden of disease study 2021. Lancet Neurol, 2024, 23(4): 344-381.
5. GBD 2021 Risk Factors Collaborators. Global burden and strength of evidence for 88 risk factors in 204 countries and 811 subnational locations, 1990-2021: a systematic analysis for the global burden of disease study 2021. Lancet, 2024, 403(10440): 2162-2203.
6. Zhao X, Li C, Ding G, et al. The burden of Alzheimer's disease mortality in the United States, 1999-2018. J Alzheimers Dis, 2021, 82(2): 803-813.
7. Katsura C, Ogunmwonyi I, Kankam HK, et al. Breast cancer: presentation, investigation and management. Br J Hosp Med (Lond), 2022, 83(2): 1-7.
8. Rouzier R, Perou CM, Symmans WF, et al. Breast cancer molecular subtypes respond differently to preoperative chemotherapy. Clin Cancer Res, 2005, 11(16): 5678-5685.
9. Safiri S, Noori M, Nejadghaderi SA, et al. Burden of female breast cancer in the Middle East and North Africa region, 1990-2019. Arch Public Health, 2022, 80(1): 168.
10. Harbeck N, Penault-Llorca F, Cortes J, et al. Breast cancer. Nat Rev Dis Primers, 2019, 5(1): 66.
11. Mubarik S, Yu Y, Wang F, et al. Epidemiological and sociodemographic transitions of female breast cancer incidence, death, case fatality and DALYs in 21 world regions and globally, from 1990 to 2017: an age-period-cohort analysis. J Adv Res, 2021, 37: 185-196.
12. GBD 2021 Diseases and Injuries Collaborators. Global incidence, prevalence, years lived with disability (YLDs), disability-adjusted life-years (DALYs), and healthy life expectancy (HALE) for 371 diseases and injuries in 204 countries and territories and 811 subnational locations, 1990-2021: a systematic analysis for the global burden of disease study 2021. Lancet, 2024, 403(10440): 2133-2161.
13. Kim HJ, Fay MP, Feuer EJ, et al. Permutation tests for joinpoint regression with applications to cancer rates. Stat Med, 2000, 19(3): 335-351.
14. Li Y, Ning Y, Shen B, et al. Temporal trends in prevalence and mortality for chronic kidney disease in China from 1990 to 2019: an analysis of the global burden of disease study 2019. Clin Kidney J, 2022, 16(2): 312-321.
15. Noordzij M, Dekker FW, Zoccali C, et al. Measures of disease frequency: prevalence and incidence. Nephron Clin Pract, 2010, 115(1): c17-c20.
16. Wilkinson L, Gathani T. Understanding breast cancer as a global health concern. Br J Radiol, 2022, 95(1130): 20211033.
17. Global Burden of Disease Cancer Collaboration, Fitzmaurice C, Allen C, et al. Global, regional, and national cancer incidence, mortality, years of life lost, years lived with disability, and disability-adjusted life-years for 32 cancer groups, 1990 to 2015: a systematic analysis for the global burden of disease study. JAMA Oncol, 2017, 3(4): 524-548.
18. Malik SS, Zia A, Rashid S, et al. XPC as breast cancer susceptibility gene: evidence from genetic profiling, statistical inferences and protein structural analysis. Breast Cancer, 2020, 27(6): 1168-1176.
19. Ma X, Liu C, Xu X, et al. Biomarker expression analysis in different age groups revealed age was a risk factor for breast cancer. J Cell Physiol, 2020, 235(5): 4268-4278.
20. Mubarik S, Wang F, Fawad M, et al. Trends and projections in breast cancer mortality among four Asian countries (1990-2017): evidence from five stochastic mortality models. Sci Rep, 2020, 10(1): 5480.
21. Mubarik S, Malik SS, Wang Z, et al. Recent insights into breast cancer incidence trends among four Asian countries using age-period-cohort model. Cancer Manag Res, 2019, 11: 8145-8155.
22. Kearney AJ. Viewpoint: It is time to reconsider policy for population-based mammography screening. J Public Health Policy, 2015, 36(3): 259-269.
23. Katalinic A, Eisemann N, Kraywinkel K, et al. Breast cancer incidence and mortality before and after implementation of the German mammography screening program. Int J Cancer, 2020, 147(3): 709-718.
24. Xu S, Liu Y, Zhang T, et al. The global, regional, and national burden and trends of breast cancer from 1990 to 2019: results from the global burden of disease study 2019. Front Oncol, 2021, 11: 689562.
25. Li N, Deng Y, Zhou L, et al. Global burden of breast cancer and attributable risk factors in 195 countries and territories, from 1990 to 2017: results from the global burden of disease study 2017. J Hematol Oncol, 2019, 12(1): 140.
26. Mubarik S, Wang F, Malik SS, et al. 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. Int J Environ Res Public Health, 2020, 17(4): 1367.
27. Arshi A, Sharifi FS, Khorramian Ghahfarokhi M, et al. Expression analysis of MALAT1, GAS5, SRA, and NEAT1 lncRNAs in breast cancer tissues from young women and women over 45 years of age. Mol Ther Nucleic Acids, 2018, 12: 751-757.
28. Youlden DR, Cramb SM, Dunn NA, et al. The descriptive epidemiology of female breast cancer: an international comparison of screening, incidence, survival and mortality. Cancer Epidemiol, 2012, 36(3): 237-248.
29. Xu Y, Gong M, Wang Y, et al. Global trends and forecasts of breast cancer incidence and deaths. Sci Data, 2023, 10(1): 334.
30. Vuong QH, Le TT, Jin R, et al. Near-suicide phenomenon: an investigation into the psychology of patients with serious illnesses withdrawing from treatment. Int J Environ Res Public Health, 2023, 20(6): 5173.
31. Tao X, Li T, Gandomkar Z, et al. Incidence, mortality, survival, and disease burden of breast cancer in China compared to other developed countries. Asia Pac J Clin Oncol, 2023, 19(6): 645-654.
32. Global Burden of Disease Cancer Collaboration, Fitzmaurice C, Akinyemiju TF, et al. Global, regional, and national cancer incidence, mortality, years of life lost, years lived with disability, and disability-adjusted life-years for 29 cancer groups, 1990 to 2016: a systematic analysis for the global burden of disease study. JAMA Oncol, 2018, 4(11): 1553-1568.
33. GBD 2016 Causes of Death Collaborators. Global, regional, and national age-sex specific mortality for 264 causes of death, 1980-2016: a systematic analysis for the global burden of disease study 2016. Lancet, 2017, 390(10100): 1151-1210.

Chinese Journal of Evidence-Based Medicine

Latest ArticlesDisease burden analysis and future trend prediction of female breast cancer in China and the worldwide from 1990 to 2021

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