Female breast cancer burden among adolescent and young adults in North Africa.

Introduction: This study examines the growing burden of breast cancer among adolescents and young adults (AYAs, ages 15-39) in North Africa from 1990 to 2021. Despite breast cancer primarily affecting postmenopausal women, its increasing incidence among AYAs presents unique clinical and biological challenges that remain under explored in North Africa.

Methods: Using Global Burden of Disease 2021 data, we analyzed temporal trends in AYA breast cancer incidence and mortality across North Africa compared to other global regions (seven GBD super regions and Central Africa, Eastern Africa, Northern Africa, Southern Africa, and Western Africa). For individual North African countries (Algeria, Egypt, Libya, Mauritania, Morocco, and Tunisia), we calculated the relative percentage change from 1990 to 2021 for all regions and the Estimated Annual Percent Change (EAPC), derived from log-linear expression models.

Results: North Africa demonstrated the second-highest global increase in AYA breast cancer incidence (166%) and third-highest increase in mortality (58%), significantly exceeding global averages. Within Africa, North Africa exhibited the steepest rise in incidence and was one of only two regions showing a statistically significant increase in mortality. In North Africa, Libya showed the most alarming trajectory with the highest annual percent change in both incidence (4.36%) and mortality (3.06%), while Algeria maintained the lowest regional mortality rates.

Interpretation: AYA breast cancer in North Africa poses challenges including limited screening, cultural barriers, and healthcare disparities. Despite varied infrastructures, rising trends demand action. Solutions include AYA-specific awareness, mobile screening, better registries, and regional collaboration for early detection and treatment.