Global, regional, and national burden of breast cancer in young women from 1990 to 2021: findings from the global burden of disease study 2021.

Abstract

Aim: The issue of breast cancer in young women (BCYW) has gained increasing attention over the past few decades. However, a notable gap exists in the literature concerning the comparison of the disease burden of BCYW with that of other age groups. This study presents a comprehensive analysis of the disparities in global, regional, and national burden between BCYW and their middle-aged and elderly counterparts.

Methods: The breast cancer data in this study were collected from the Global Burden of Diseases, Injuries, and Risk Factors Study 2021 (GBD 2021). The age-standardized incidence rate (ASIR), age-standardized mortality rate (ASMR), age-standardized prevalence rate (ASPR), and age-standardized disability-adjusted life years rate (ASDR), and the Average Annual Percent Change (AAPC) were employed to assess the disease burden of BCYW. The Bayesian Age-Period-Cohort model was used to forecast disease burden from 2022 to 2030.

Results: The AAPC of ASIR of BCYW from 1990 to 2021 was 0.91 (95% CI: 0.77 to 1.05), exceeding the global average (0.49, 95% CI: 0.40 to 0.58) as well as both middle-aged (0.60, 95% CI: 0.47 to 0.73) and elderly groups (0.30, 95% CI: 0.21 to 0.39). The AAPC for ASMR of BCYW experienced a marginal increase of 0.02 (95%CI: -0.07 to 0.11) from 1990 to 2021, surpassing the rates observed in both the middle-aged group (-0.40, 95%CI: -0.47 to -0.32) and the elderly group (-0.50, 95%CI: -0.62 to -0.38). The ASIR in BCYW significantly increased in regions with low (AAPC = 1.87), low-middle (AAPC = 2.32), middle (AAPC = 1.84), and high-middle SDI (AAPC = 0.98), while it remained unchanged in regions with high SDI (AAPC = -0.02). This trend was also observed among middle-aged and older groups. The ASMR in BCYW significantly increased in regions with low (AAPC = 1.01) and low-middle SDI (AAPC = 1.25), but remained unchanged in regions with middle SDI (AAPC = 0.02), while it decreased in regions with high-middle (AAPC = -1.10) and high SDI (AAPC = -1.60). Among the middle-aged and elderly populations, there was an increase in ASMR rates observed in regions with low, low-middle, and middle SDI groups (all AAPC > 0), whereas a decrease was noted in the regions with high-middle and high SDI (all AAPC < 0). The BAPC predicts a consistent annual increase in ASIR, ASMR, ASPR, and ASDR of BCYW globally and in China from 2022 to 2030. Notably, China has higher ASIR and ASPR rates compared to the global average, while its ASMR and ASDR rates are lower.

Conclusion: The burden of BCYW was particularly significant in regions with low-SDI, low-middle SDI, and middle SDI. Despite the progress made, China still faces considerable challenges in effectively addressing this issue. The prevention and control of BCYW must remain a priority. Different countries and regions should develop personalized, targeted intervention strategies for this population and establish public health policies tailored to the specific needs of each region.