Burden of Breast Cancer Attributable to a Diet High in Red Meat at Global, Regional, and National Levels: An Analysis of the Global Burden of Disease Study 2021.

Abstract

Background: Dietary factors are a key risk for breast cancer. This study examines the global burden of breast cancer attributed to a high red meat diet from 1990 to 2021.

Methods: Using Global Burden of Disease Study (GBD) 2021 data, deaths and disability-adjusted life-years (DALYs) were analyzed globally, regionally, and nationally. Trends were assessed through estimated annual percentage changes (EAPCs) in age-standardized mortality (ASMR) and DALY (ASDR) rates. A decomposition analysis quantified the contributions of population growth, aging, and epidemiological changes. The relationship between sociodemographic index (SDI) and burden was examined using Spearman rank test. Health inequalities were assessed using the Slope Index of Inequality for absolute inequality and the Concentration Index for relative inequality.

Results: By 2021, breast cancer deaths and DALYs linked to high red meat intake had increased significantly compared to 1990, despite a decline in ASMR [EAPC: -0.77 (95% CI -0.82 to -0.72)] and ASDR [EAPC: -0.65 (95% CI -0.70 to -0.60)]. These trends were driven by population growth and aging, with regional variability in the pace of demographic transitions. North Africa and the Middle East experienced the largest rise in ASMR [EAPC: 2.03 (95% CI 1.79 to 2.26)], while Pacific Island nations had the highest ASMR and ASDR. High-SDI regions had the highest ASMR [1.14 per 100000 (95% UI -0.01‒2.43)] and ASDR [33.07 per 100000 (95% UI -0.02‒69.90)], with a positive SDI-burden correlation in low- and middle-SDI regions (P<0.05), but a negative correlation in high-SDI regions (P<0.05). From 1990 to 2021, absolute inequality [35.79 (95% CI 29.13‒42.46) vs. 4.99 (95% CI -1.59-11.56)] and relative inequality [0.18 (95% CI 0.16‒0.21) vs. 0.02 (95% CI -0.01‒0.05)] decreased.

Conclusion: Although ASMR and ASDR have declined, the absolute burden of breast cancer due to high red meat intake remains significant, particularly in aging and rapidly urbanizing populations. Policy interventions should include taxation on red meat, restrictions on processed meat, and public health campaigns promoting dietary modifications. Targeted screening programs in high-risk regions, especially for middle-aged and elderly populations, are critical for mitigating the future disease burden.