Zhang Min, Yuan Linlin, Cui Meimei, Chen Jiayi, Jia Jingjing, Zhao Ming, Zhou Dan, Zhu Liling, Luo Limei
Maternal and Child Health Development Research Center, Shandong Provincial Maternal and Child Health Care Hospital Affiliated to Qingdao University, Jinan, Shandong, China.
School of Public Health, Jiamusi University, Jiamusi, Heilongjiang, China.
Ann Surg Oncol. 2025 Mar;32(3):2056-2069. doi: 10.1245/s10434-024-16648-0. Epub 2024 Dec 12.
Unique features and worse outcomes have been reported for breast cancers among adolescents and young adults (AYAs; age 15-39 years). However, there are few up-to-date and comprehensive data to analyze the disease burden of AYA breast cancer.
The data of incidence, deaths, and disability-adjusted life years (DALYs) owing to breast cancer was obtained from the Global Burden of Disease (GBD) 2021. We computed estimated annual percentage changes (EAPCs) of each indicator to capture the secular trend in breast cancer and conducted a decomposition analysis to examine factors behind DALYs changes. We also predicted the incident cases, deaths and DALYs to 2044.
From 1990 to 2021, the age-standardized incidence rate (ASIR) experienced an increasing trend globally [EAPC: 0.87, 95% confidence interval (CI) 0.77-0.97]. The age-standardized rates (ASRs) of male AYAs breast cancer were all on the rise. The most significant increase trends in ASRs among female AYAs occurred in North Africa and Middle East, while male AYAs showed the highest increases in East Asia. Population growth contributed the most to the growth of DALYs in East Asia. Frontier analysis showed that despite limited resources, some underdeveloped countries still exhibit superior performance, while other countries with higher sociodemographic index have great room for improvement.
The global burden of AYAs breast cancer is grim, especially in North Africa and Middle East. The significant increase in male AYAs breast cancer burden, targeted prevention strategies may need to be developed for AYAs breast cancer by sex and countries.
据报道，青少年和青年（15 - 39岁）乳腺癌具有独特特征且预后较差。然而，目前几乎没有最新的综合数据来分析青少年和青年乳腺癌的疾病负担。
乳腺癌的发病率、死亡率和伤残调整生命年（DALYs）数据来自《2021年全球疾病负担》（GBD）。我们计算了每个指标的估计年度百分比变化（EAPCs）以捕捉乳腺癌的长期趋势，并进行了分解分析以研究DALYs变化背后的因素。我们还预测了到2044年的发病病例、死亡人数和DALYs。
从1990年到2021年，全球年龄标准化发病率（ASIR）呈上升趋势[EAPC：0.87，95%置信区间（CI）0.77 - 0.97]。青少年和青年男性乳腺癌的年龄标准化发病率均呈上升趋势。青少年和青年女性中，发病率上升趋势最显著的是北非和中东地区，而青少年和青年男性发病率上升最高的是东亚地区。人口增长对东亚地区DALYs的增长贡献最大。前沿分析表明，尽管资源有限，但一些欠发达国家仍表现出色，而其他社会人口指数较高的国家仍有很大的改进空间。
青少年和青年乳腺癌的全球负担严峻，尤其是在北非和中东地区。青少年和青年男性乳腺癌负担显著增加，可能需要针对不同性别和国家制定青少年和青年乳腺癌的预防策略。
