Global patterns, temporal trends and socioeconomic inequalities in the burden of breast cancer: a population-based study across 185 countries

Abstract

Objective: Breast cancer is the most frequently diagnosed cancer among women worldwide and is a leading cause of cancer-related deaths. Comparative assessments of breast cancer lifetime risks across populations are limited. This study estimated the global, regional, and national lifetime risks, temporal trends, and socioeconomic inequalities in the burden of breast cancer. Methods: Using incidence and mortality data from GLOBOCAN 2022 (185 countries) and United Nations population and all-cause death data, lifetime risks were calculated using the adjusted for multiple primaries (AMP) method, which could adjust for multiple primary cancers, competing risks of other causes death, and life expectancy. Longitudinal data of breast cancer incidence from 2003–2017 were retrieved from the Cancer Incidence in Five Continents (CI5) Plus database. The temporal trends for breast cancer deaths were abstracted from the WHO Mortality Database. The lifetime risk of developing and dying from breast cancer were analyzed by socioeconomic characteristics, 20 predefined geographic regions and menopausal status. Results: The overall worldwide lifetime risk of developing and dying from breast cancer was 5.51% (95% CI: 5.50%–5.52%) and 1.82% (95% CI: 1.82%–1.83%) in 2022, respectively. The estimated lifetime risks of developing breast cancer had a positive relationship with Human Development Index (HDI) levels and corresponding risks of 10.37%, 4.42%, 2.96%, and 2.91% in very high, high, middle, and low HDI regions, respectively. Very high HDI regions presented the highest lifetime risk of breast cancer death (2.70%), followed by low HDI (1.70%), medium HDI (1.54%), and high (1.38%) HDI regions. A significant correlation was identified between lifetime risks and health economics capacity. The lifetime risk of developing and dying from breast cancer primarily involved individuals ≥ 55 years of age with remaining risks of 3.77% (developing) and 1.43% (dying) from 55 years to death. The proportion of lifetime risks among individuals 0–44 years of age was higher in Africa regions compared to other regions. In surveillance data from 36 countries, a significant increasing trend in the average annual percentage change (AAPC) was noted in 32 countries, which ranged from 0.17% in the United States to 5.84% in the Republic of Korea. Conclusions: Globally, an estimated 1 in 18 individuals were diagnosed with breast cancer during their lifetime and approximately 1 in 55 died from the disease in 2022. Lifetime risk of breast cancer disparities reveal the socioeconomic inequalities of breast cancer. Therefore, country-tailored intervention plans for breast cancer require prioritization within precision prevention to mitigate global breast cancer inequities and burden.