Zhou Fang, Tang Jincheng, Yang Renyi, Zeng Puhua, Cao Jianxiong
Hunan Provincial Hospital of Integrated Traditional Chinese and Western Medicine, Hunan University of Chinese Medicine, Changsha, Hunan, China.
Institute of Traditional Chinese Medicine Oncology, Hunan Academy of Chinese Medicine, Changsha, Hunan, China.
Arch Iran Med. 2025 May 1;28(5):275-285. doi: 10.34172/aim.34079.
Dietary factors are a key risk for breast cancer. This study examines the global burden of breast cancer attributed to a high red meat diet from 1990 to 2021.
Using Global Burden of Disease Study (GBD) 2021 data, deaths and disability-adjusted life-years (DALYs) were analyzed globally, regionally, and nationally. Trends were assessed through estimated annual percentage changes (EAPCs) in age-standardized mortality (ASMR) and DALY (ASDR) rates. A decomposition analysis quantified the contributions of population growth, aging, and epidemiological changes. The relationship between sociodemographic index (SDI) and burden was examined using Spearman rank test. Health inequalities were assessed using the Slope Index of Inequality for absolute inequality and the Concentration Index for relative inequality.
By 2021, breast cancer deaths and DALYs linked to high red meat intake had increased significantly compared to 1990, despite a decline in ASMR [EAPC: -0.77 (95% CI -0.82 to -0.72)] and ASDR [EAPC: -0.65 (95% CI -0.70 to -0.60)]. These trends were driven by population growth and aging, with regional variability in the pace of demographic transitions. North Africa and the Middle East experienced the largest rise in ASMR [EAPC: 2.03 (95% CI 1.79 to 2.26)], while Pacific Island nations had the highest ASMR and ASDR. High-SDI regions had the highest ASMR [1.14 per 100000 (95% UI -0.01‒2.43)] and ASDR [33.07 per 100000 (95% UI -0.02‒69.90)], with a positive SDI-burden correlation in low- and middle-SDI regions (<0.05), but a negative correlation in high-SDI regions (<0.05). From 1990 to 2021, absolute inequality [35.79 (95% CI 29.13‒42.46) vs. 4.99 (95% CI -1.59-11.56)] and relative inequality [0.18 (95% CI 0.16‒0.21) vs. 0.02 (95% CI -0.01‒0.05)] decreased.
Although ASMR and ASDR have declined, the absolute burden of breast cancer due to high red meat intake remains significant, particularly in aging and rapidly urbanizing populations. Policy interventions should include taxation on red meat, restrictions on processed meat, and public health campaigns promoting dietary modifications. Targeted screening programs in high-risk regions, especially for middle-aged and elderly populations, are critical for mitigating the future disease burden.
饮食因素是乳腺癌的关键风险因素。本研究调查了1990年至2021年因高红肉饮食导致的全球乳腺癌负担。
利用全球疾病负担研究(GBD)2021年的数据,对全球、区域和国家层面的死亡人数和伤残调整生命年(DALYs)进行了分析。通过年龄标准化死亡率(ASMR)和DALY(ASDR)率的估计年百分比变化(EAPCs)评估趋势。分解分析量化了人口增长、老龄化和流行病学变化的贡献。使用Spearman秩检验研究社会人口指数(SDI)与负担之间的关系。使用绝对不平等的不平等斜率指数和相对不平等的集中指数评估健康不平等。
到2021年,尽管ASMR [EAPC:-0.77(95%CI -0.82至-0.72)]和ASDR [EAPC:-0.65(95%CI -0.70至-0.60)]有所下降,但与高红肉摄入量相关的乳腺癌死亡人数和DALYs与1990年相比显著增加。这些趋势是由人口增长和老龄化驱动的,人口转变速度存在区域差异。北非和中东的ASMR上升幅度最大[EAPC:2.03(95%CI 1.79至2.26)],而太平洋岛国的ASMR和ASDR最高。高SDI地区的ASMR [每100000人中有1.14例(95%UI -0.01‒2.43)]和ASDR [每100000人中有33.07例(95%UI -0.02‒69.90)]最高,在低和中等SDI地区,SDI与负担呈正相关(<0.05),但在高SDI地区呈负相关(<0.05)。从1990年到2021年,绝对不平等[35.79(95%CI 29.13‒42.46)对4.99(95%CI -1.59 - 11.56)]和相对不平等[0.18(95%CI 0.16‒0.21)对0.02(95%CI -0.01‒0.05)]有所下降。
尽管ASMR和ASDR有所下降,但高红肉摄入量导致的乳腺癌绝对负担仍然很大,特别是在老龄化和快速城市化的人群中。政策干预应包括对红肉征税、限制加工肉类以及开展促进饮食调整的公共卫生运动。在高风险地区,特别是针对中老年人群的有针对性的筛查项目对于减轻未来疾病负担至关重要。