Xu Shangbo, Liu Yiyuan, Zhang Taofeng, Zheng Jiehua, Lin Weixun, Cai Jiehui, Zou Juan, Chen Yaokun, Xie Yanna, Chen Yexi, Li Zhiyang
Department of Internal Medicine, People's Hospital of Jieyang, Jieyang Hospital Affiliated to SunYat-sen University, Jieyang, China.
Department of General Surgery, The Second Affiliated Hospital of Shantou University Medical College, Shantou, China.
Front Oncol. 2021 May 21;11:689562. doi: 10.3389/fonc.2021.689562. eCollection 2021.
The burden of breast cancer has been increasing globally. The epidemiology burden and trends need to be updated. This study aimed to update the burden and trends of breast cancer incidences, deaths, and disability-adjusted life-years (DALYs) from 1990 to 2019, using the Global Burden of Disease 2019 study.
The data of incidences, deaths, DALYs, and age-standardized rates were extracted. Estimated annual percentage changes were used to quantify the trends of age-standardized rates. Besides, the population attributable fractions of the risk factors of breast cancer were also estimated.
Globally, the incidences of breast cancer increased to 2,002,354 in 2019. High social-development index (SDI) quintiles had the highest incidence cases with a declining trend in age-standardized incidence rate. In 2019, the global deaths and DALYs of breast cancer increased to 700,660 and 20,625,313, respectively. From 1990 to 2019, the age-standardized mortality rates and age-standardized DALY rates declined globally, especially in high and high-middle SDI quintiles. Besides, the trends varied from different regions and countries. The proportion of the patients in the 70+ years age group increased globally. Deaths of breast cancer attributable to high fasting plasma glucose and high body mass index increased globally, and high fasting plasma glucose was the greatest contributor to the global breast cancer deaths.
The burden of breast cancer in higher SDI quintiles had gone down while the burden was still on the rise in lower SDI quintiles. It is necessary to appeal to the public to decrease the exposure of the risk factors.
全球乳腺癌负担一直在增加。流行病学负担和趋势需要更新。本研究旨在利用《2019年全球疾病负担研究》更新1990年至2019年乳腺癌发病率、死亡率和伤残调整生命年（DALYs）的负担及趋势。
提取发病率、死亡率、伤残调整生命年和年龄标准化率的数据。使用估计的年百分比变化来量化年龄标准化率的趋势。此外，还估计了乳腺癌危险因素的人群归因分数。
全球范围内，2019年乳腺癌发病率增至2002354例。社会发展指数（SDI）高五分位数地区发病率最高，且年龄标准化发病率呈下降趋势。2019年，全球乳腺癌死亡人数和伤残调整生命年分别增至700660例和20625313例。1990年至2019年，全球年龄标准化死亡率和年龄标准化伤残调整生命年率下降，尤其是在高SDI五分位数和高中等SDI五分位数地区。此外，不同地区和国家的趋势有所不同。全球70岁及以上年龄组患者的比例有所增加。因空腹血糖高和体重指数高导致的乳腺癌死亡人数在全球范围内增加，空腹血糖高是全球乳腺癌死亡的最大促成因素。
高SDI五分位数地区的乳腺癌负担有所下降，而低SDI五分位数地区的负担仍在上升。有必要呼吁公众减少危险因素的暴露。
