1990年至2021年204个国家和地区的乳腺癌全球负担及可归因风险因素：全球疾病负担研究2021的结果
Global burden of breast cancer and attributable risk factors in 204 countries and territories, from 1990 to 2021: results from the Global Burden of Disease Study 2021.
作者信息
Sha Rui, Kong Xiang-Meng, Li Xin-Yu, Wang Ya-Bing
机构信息
Department of Thyroid and Breast Surgery, The First Affiliated Hospital of Wannan Medical College (Yijishan Hospital of Wannan Medical College), Zheshan West Rd No. 2, Wuhu , Anhui Province, 241001, China.
Department of Cardiology, Shanghai Ninth People,s Hospital, Shanghai Jiao Tong University School of Medicine, No.639 Zhizaoju Road, Shanghai, Huangpu District, 200011, China.
出版信息
Biomark Res. 2024 Aug 26;12(1):87. doi: 10.1186/s40364-024-00631-8.
BACKGROUND AND OBJECTIVE
Breast cancer is a leading cause of morbidity and mortality among women worldwide. This study aimed to assess the global burden of breast cancer and identify attributable risk factors across 204 countries and territories from 1990 to 2021.
METHODS
Using data from the Global Burden of Disease Study 2021, we analyzed the incidence, mortality, disability-adjusted life years (DALYs), and risk factors associated with breast cancer. We obtained and analyzed the age-standardized incidence rate (ASIR), age-standardized death rate (ASDR), and age-standardized DALYs rate from 1990 to 2021. We assessed geographical variations and the impact of the Socio-demographic Index (SDI) using regression analysis and stratification by SDI quintiles. Additionally, we estimated the risk factors attributable to breast cancer deaths and DALYs using the comparative risk assessment framework of the GBD study.
RESULTS
Globally, breast cancer incident cases increased from 875,657 in 1990 to 2,121,564 in 2021. The ASIR rose from 16.42 to 26.88 per 100,000 (95% CI: 1.54-1.60). High SDI regions showed the highest ASIR (66.89 per 100,000 in 2021), while Low SDI regions had the lowest (6.99 per 100,000 in 2021). The global ASDR decreased from 10.42 to 8.54 per 100,000, and the age-standardized DALYs rate decreased from 313.36 to 261.5 per 100,000 between 1990 and 2021. However, these improvements were not uniform across SDI regions. Risk factors included high body-mass index, alcohol use, tobacco, and high fasting plasma glucose, with variations across SDI regions.
CONCLUSION
The global burden of breast cancer has increased significantly from 1990 to 2021, with disparities observed across SDI regions. While high SDI areas show improvements in mortality and DALYs, lower SDI regions face increasing burdens. Targeted interventions addressing modifiable risk factors and improving healthcare access in less developed regions are crucial for reducing the global impact of breast cancer.
背景与目的
乳腺癌是全球女性发病和死亡的主要原因。本研究旨在评估1990年至2021年期间204个国家和地区的乳腺癌全球负担，并确定可归因的风险因素。
方法
利用《2021年全球疾病负担研究》的数据，我们分析了乳腺癌的发病率、死亡率、伤残调整生命年（DALYs）以及相关风险因素。我们获取并分析了1990年至2021年的年龄标准化发病率（ASIR）、年龄标准化死亡率（ASDR）和年龄标准化DALYs率。我们使用回归分析和按社会人口指数（SDI）五分位数分层的方法评估地理差异和SDI的影响。此外，我们使用全球疾病负担研究的比较风险评估框架估计了可归因于乳腺癌死亡和DALYs的风险因素。
结果
全球范围内，乳腺癌发病病例从1990年的875,657例增加到2021年的2,121,564例。ASIR从每10万人16.42例上升至26.88例（95%置信区间：1.54 - 1.60）。高SDI地区的ASIR最高（2021年为每10万人66.89例），而低SDI地区最低（2021年为每10万人6.99例）。1990年至2021年期间，全球ASDR从每10万人10.42例降至8.54例，年龄标准化DALYs率从每10万人313.36例降至261.5例。然而，这些改善在不同SDI地区并不均匀。风险因素包括高体重指数、饮酒、吸烟和高空腹血糖，不同SDI地区存在差异。
结论
1990年至2021年期间，乳腺癌的全球负担显著增加，不同SDI地区存在差异。虽然高SDI地区在死亡率和DALYs方面有所改善，但低SDI地区面临的负担却在增加。针对可改变的风险因素采取有针对性的干预措施，并改善欠发达地区的医疗服务可及性，对于降低乳腺癌的全球影响至关重要。
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