School of Public Health, Guilin Medical University, 1 Zhiyuan Road, Guilin, Guangxi, 541199, P.R. China.
University Hospital for Gynecology, Pius-Hospital, University Medicine Oldenburg, 26121, Oldenburg, Germany.
BMC Cancer. 2021 Apr 24;21(1):459. doi: 10.1186/s12885-021-08217-5.
Female breast cancer (FBC) is a malignancy involving multiple risk factors and has imposed heavy disease burden on women. We aim to analyze the secular trends of mortality rate of FBC according to its major risk factors.
Death data of FBC at the global, regional, and national levels were retrieved from the online database of Global Burden of Disease study 2017. Deaths of FBC attributable to alcohol use, high body-mass index (BMI), high fasting plasma glucose (FPG), low physical activity, and tobacco were collected. Estimated average percentage change (EAPC) was used to quantify the temporal trends of age-standardized mortality rate (ASMR) of FBC in 1990-2017.
Worldwide, the number of deaths from FBC increased from 344.9 thousand in 1990 to 600.7 thousand in 2017. The ASMR of FBC decreased by 0.59% (95% CI, 0.52, 0.66%) per year during the study period. This decrease was largely driven by the reduction in alcohol use- and tobacco-related FBC, of which the ASMR was decreased by 1.73 and 1.77% per year, respectively. In contrast, the ASMR of FBC attributable to high BMI and high FPG was increased by 1.26% (95% CI, 1.22, 1.30%) and 0.26% (95% CI, 0.23, 0.30%) per year between 1990 and 2017, respectively.
The mortality rate of FBC experienced a reduction over the last three decades, which was partly owing to the effective control for alcohol and tobacco use. However, more potent and tailored prevention strategies for obesity and diabetes are urgently warranted.
女性乳腺癌（FBC）是一种涉及多种风险因素的恶性肿瘤，给女性带来了沉重的疾病负担。我们旨在分析 FBC 死亡率的长期趋势及其主要危险因素。
从 2017 年全球疾病负担研究的在线数据库中检索了全球、区域和国家各级 FBC 的死亡数据。收集了归因于饮酒、高体重指数（BMI）、高空腹血糖（FPG）、低身体活动和烟草使用的 FBC 死亡人数。使用估计平均百分比变化（EAPC）来量化 1990-2017 年 FBC 年龄标准化死亡率（ASMR）的时间趋势。
全世界 FBC 死亡人数从 1990 年的 34.49 万增加到 2017 年的 60.07 万。在研究期间，FBC 的 ASMR 每年下降 0.59%（95%CI，0.52，0.66%）。这种下降主要归因于饮酒和烟草相关 FBC 的减少，其 ASMR 分别每年下降 1.73%和 1.77%。相比之下，高 BMI 和高 FPG 导致的 FBC 的 ASMR 分别每年增加 1.26%（95%CI，1.22，1.30%）和 0.26%（95%CI，0.23，0.30%）。
在过去三十年中，FBC 的死亡率有所下降，部分原因是有效控制了酒精和烟草的使用。然而，迫切需要更有力和有针对性的肥胖和糖尿病预防策略。
