Priyadarshini Subhadra, Panda Kunja Bihari
Department of Statistics Utkal University Bhubaneswar Odisha India.
Department of Statistics Central University of Jharkhand Ranchi India.
Aging Med (Milton). 2024 Dec 25;7(6):770-780. doi: 10.1002/agm2.12382. eCollection 2024 Dec.
Breast cancer is a leading cause of morbidity and mortality among women worldwide. This study aims to analyze the trends in breast cancer incidence, mortality, and disability-adjusted life years (DALYs) across different age groups from 1990 to 2021, and to project the mortality rate for the next decade.
Global breast cancer data were analyzed, focusing on three distinct age groups: 15-49 years, 50-69 years, and 70+ years. Joinpoint regression analysis was used to identify periods of significant changes in cancer rate trends (joinpoints). Age-specific annual percent changes (APC) and average annual percent changes (AAPC) were calculated to identify trends over time. Additionally, an autoregressive integrated moving average (ARIMA) model was employed to forecast future mortality rates.
The overall incidence of breast cancer increased significantly with an AAPC of 1.6% from 1990 to 2021. The highest increase was observed in the 15-49 years age group (AAPC: 1.3%), while the 70+ years age group showed the lowest increase (AAPC: 0.2%). Mortality rates exhibited a complex pattern, with a modest overall increase (AAPC: 0.8%), a slight increase in the 15-49 years age group (AAPC: 0.4%), and decreases in both 50 and 69 years (AAPC: -0.4%) and 70+ years age groups (AAPC: -0.3%). DALY rates increased slightly overall (AAPC: 0.7%), primarily driven by the 15-49 years age group (AAPC: 0.4%), while the older age groups showed a declining trend (AAPC: -0.4%).
Incidence rates are rising across all age groups, with the highest increase observed among younger women (15-49 years). In contrast, older age groups (50 + years) are experiencing improvements in mortality and DALYs. These findings underscore the need for targeted public health interventions, enhanced screening practices, and ongoing advancements in breast cancer treatment to address the evolving burden of this disease across different age groups.
乳腺癌是全球女性发病和死亡的主要原因。本研究旨在分析1990年至2021年不同年龄组乳腺癌发病率、死亡率和伤残调整生命年（DALYs）的趋势，并预测未来十年的死亡率。
分析全球乳腺癌数据，重点关注三个不同年龄组：15 - 49岁、50 - 69岁和70岁及以上。采用Joinpoint回归分析确定癌症发病率趋势的显著变化时期（连接点）。计算特定年龄的年度百分比变化（APC）和平均年度百分比变化（AAPC）以确定随时间的趋势。此外，使用自回归积分移动平均（ARIMA）模型预测未来死亡率。
1990年至2021年，乳腺癌总体发病率显著上升，AAPC为1.6%。15 - 49岁年龄组上升幅度最大（AAPC：1.3%），而70岁及以上年龄组上升幅度最小（AAPC：0.2%）。死亡率呈现复杂模式，总体略有上升（AAPC：0.8%），15 - 49岁年龄组略有上升（AAPC：0.4%），50至69岁（AAPC： - 0.4%）和70岁及以上年龄组均下降（AAPC： - 0.3%）。DALY率总体略有上升（AAPC：0.7%），主要由15 - 49岁年龄组推动（AAPC：0.4%），而老年组呈下降趋势（AAPC： - 0.4%）。
所有年龄组的发病率都在上升，年轻女性（15 - 49岁）上升幅度最大。相比之下，老年组（50岁及以上）的死亡率和伤残调整生命年有所改善。这些发现强调需要有针对性的公共卫生干预措施、加强筛查实践以及乳腺癌治疗的持续进展，以应对不同年龄组这种疾病不断变化的负担。
