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低收入和中等收入国家乳腺癌的疾病负担、风险因素及时间趋势:一项全球研究。

Disease Burden, Risk Factors, and Temporal Trends in Breast Cancer in Low- and Middle-Income Countries: A Global Study.

作者信息

Gao Mingjun, Wik Sofia Laila, Yu QinYao, Xue FanYu, Chan Sze Chai, Chow Shui Hang, Adebisi Yusuff Adebayo, Zhong Claire Chenwen, Lucero-Prisno Don Eliseo, Wong Martin Cs, Huang Junjie

机构信息

The Jockey Club School of Public Health and Primary Care Faculty of Medicine The Chinese University of Hong Kong Hong Kong SAR China.

Adam Smith Business School College of Social Science University of Glasgow Glasgow UK.

出版信息

Public Health Chall. 2024 Jul 29;3(3):e223. doi: 10.1002/puh2.223. eCollection 2024 Sep.

Abstract

INTRODUCTION

Breast cancer poses significant health risks to women and strains healthcare systems extensively. In low- and middle-income countries (LMICs), limited resources and inadequate healthcare infrastructures further exacerbate the challenges of breast cancer prevention, treatment, and awareness.

METHODS

We examined the prevalence, risk factors, and trends of breast cancer in LMICs. Data on disability-adjusted life years (DALYs) and breast cancer risk factors were extracted from the Global Burden of Disease (GBD) databases for 203 countries or territories from 1990 to 2019. LMIC DALY rates were examined using joinpoint regression analysis.

RESULTS

Among the income groups, the lower middle-income category had the highest DALYs value, with 1787 years per 100,000 people. LMICs collectively accounted for 74% of the global burden of DALYs lost due to breast cancer in 2019. However, it remained relatively consistent in lower middle income countries (LMCs). In LMCs, the risk associated with metabolic syndromes was higher compared to that with behavioral factors alone. For the past three decades, breast cancer incidences increased significantly in LMCs (average annual percent change [AAPC]: 1.212, confidence intervals [CI]: 1.51-1.87,  < 0.001), upper middle income countries (AAPC: 1.701, CI: 1.12-1.48,  < 0.001), and low-income countries (AAPC: 1.002, CI: 1.57-1.68,  < 0.001).

CONCLUSION

This research shows how breast cancer in LMICs is aggravated by low resources and healthcare infrastructure. To effectively combat breast cancer in these areas, future strategies must prioritize improvements in healthcare infrastructure, awareness campaigns, and early detection mechanisms.

摘要

引言

乳腺癌对女性健康构成重大风险,并给医疗系统带来巨大压力。在低收入和中等收入国家(LMICs),资源有限和医疗基础设施不足进一步加剧了乳腺癌预防、治疗及提高认知方面的挑战。

方法

我们研究了低收入和中等收入国家乳腺癌的患病率、风险因素及趋势。从1990年至2019年全球疾病负担(GBD)数据库中提取了203个国家或地区的伤残调整生命年(DALYs)和乳腺癌风险因素数据。使用Joinpoint回归分析检查了低收入和中等收入国家的DALY率。

结果

在各收入组中,中低收入类别DALY值最高,每10万人中有1787年。2019年,低收入和中等收入国家合计占全球因乳腺癌导致的伤残调整生命年损失负担的74%。然而,在中低收入国家(LMCs),这一负担相对保持稳定。在中低收入国家,与代谢综合征相关的风险高于仅与行为因素相关的风险。在过去三十年中,中低收入国家(平均年变化百分比[AAPC]:1.212,置信区间[CI]:1.51 - 1.87,<0.001)、中高收入国家(AAPC:1.701,CI:1.12 - 1.48,<0.001)和低收入国家(AAPC:1.002,CI:1.57 - 1.68,<0.001)的乳腺癌发病率均显著上升。

结论

本研究表明低收入和中等收入国家的低资源和医疗基础设施如何加剧了乳腺癌问题。为有效应对这些地区的乳腺癌,未来战略必须优先改善医疗基础设施、开展宣传活动并建立早期检测机制。

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