Global patterns and trends in the breast cancer incidence and mortality according to sociodemographic indices: an observational study based on the global burden of diseases

Objectives Disparities in the global burden of breast cancer have been identified. We aimed to investigate recent patterns and trends in the breast cancer incidence and associated mortality. We also assessed breast cancer-related health inequalities according to socioeconomic development factors.Des...

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Main Authors: Kaimin Hu, Peili Ding, Yinan Wu, Wei Tian, Tao Pan, Suzhan Zhang
Format: Article
Language:English
Published: BMJ Publishing Group 2019-10-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/9/10/e028461.full
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author Kaimin Hu
Peili Ding
Yinan Wu
Wei Tian
Tao Pan
Suzhan Zhang
author_facet Kaimin Hu
Peili Ding
Yinan Wu
Wei Tian
Tao Pan
Suzhan Zhang
author_sort Kaimin Hu
collection DOAJ
description Objectives Disparities in the global burden of breast cancer have been identified. We aimed to investigate recent patterns and trends in the breast cancer incidence and associated mortality. We also assessed breast cancer-related health inequalities according to socioeconomic development factors.Design An observational study based on the Global Burden of Diseases.Methods Estimates of breast cancer incidence and mortality during 1990–2016 were obtained from the Global Health Data Exchange database. Subsequently, data obtained in 2016 were described using the age-standardised and age-specific incidence, mortality and mortality-to-incidence (MI) ratios according to sociodemographic index (SDI) levels. Trends were assessed by measuring the annual percent change using the joinpoint regression. The Gini coefficients and concentration indices were used to identify between-country inequalities.Results Countries with higher SDI levels had worse disease incidence burdens in 2016, whereas inequalities in the breast cancer incidence had decreased since 1990. Opposite trends were observed in the mortality rates of high and low SDI countries. Moreover, the decreasing concentration indices, some of which became negative, among women aged 15–49 and 50–69 years suggested an increase in the mortality burdens in undeveloped regions. Conversely, inequality related to the MI ratio increased. In 2016, the MI ratios exhibited distinct gradients from high to low SDI regions across all age groups.Conclusions The patterns and trends in breast cancer incidence and mortality closely correlated with the SDI levels. Our findings highlighted the primary prevention of breast cancer in high SDI countries with a high disease incidence and the development of cost-effective diagnostic and treatment interventions for low SDI countries with poor MI ratios as the two pressing needs in the next decades.
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spelling doaj-art-75606d8aad0e44a2a94c9637ebf2b6132025-08-20T02:50:32ZengBMJ Publishing GroupBMJ Open2044-60552019-10-0191010.1136/bmjopen-2018-028461Global patterns and trends in the breast cancer incidence and mortality according to sociodemographic indices: an observational study based on the global burden of diseasesKaimin Hu0Peili Ding1Yinan Wu2Wei Tian3Tao Pan4Suzhan Zhang51 Cancer Institute, The Second Affiliated Hospital of Zhejiang University, College of Medicine, Hangzhou, Zhejiang, China1 Cancer Institute, The Second Affiliated Hospital of Zhejiang University, College of Medicine, Hangzhou, Zhejiang, ChinaDepartment of Pathology, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, Jiangsu, China2 First Affiliated Hospital, Dalian Medical University, Dalian, Liaoning, China1 Cancer Institute, The Second Affiliated Hospital of Zhejiang University, College of Medicine, Hangzhou, Zhejiang, China1 Cancer Institute, The Second Affiliated Hospital of Zhejiang University, College of Medicine, Hangzhou, Zhejiang, ChinaObjectives Disparities in the global burden of breast cancer have been identified. We aimed to investigate recent patterns and trends in the breast cancer incidence and associated mortality. We also assessed breast cancer-related health inequalities according to socioeconomic development factors.Design An observational study based on the Global Burden of Diseases.Methods Estimates of breast cancer incidence and mortality during 1990–2016 were obtained from the Global Health Data Exchange database. Subsequently, data obtained in 2016 were described using the age-standardised and age-specific incidence, mortality and mortality-to-incidence (MI) ratios according to sociodemographic index (SDI) levels. Trends were assessed by measuring the annual percent change using the joinpoint regression. The Gini coefficients and concentration indices were used to identify between-country inequalities.Results Countries with higher SDI levels had worse disease incidence burdens in 2016, whereas inequalities in the breast cancer incidence had decreased since 1990. Opposite trends were observed in the mortality rates of high and low SDI countries. Moreover, the decreasing concentration indices, some of which became negative, among women aged 15–49 and 50–69 years suggested an increase in the mortality burdens in undeveloped regions. Conversely, inequality related to the MI ratio increased. In 2016, the MI ratios exhibited distinct gradients from high to low SDI regions across all age groups.Conclusions The patterns and trends in breast cancer incidence and mortality closely correlated with the SDI levels. Our findings highlighted the primary prevention of breast cancer in high SDI countries with a high disease incidence and the development of cost-effective diagnostic and treatment interventions for low SDI countries with poor MI ratios as the two pressing needs in the next decades.https://bmjopen.bmj.com/content/9/10/e028461.full
spellingShingle Kaimin Hu
Peili Ding
Yinan Wu
Wei Tian
Tao Pan
Suzhan Zhang
Global patterns and trends in the breast cancer incidence and mortality according to sociodemographic indices: an observational study based on the global burden of diseases
BMJ Open
title Global patterns and trends in the breast cancer incidence and mortality according to sociodemographic indices: an observational study based on the global burden of diseases
title_full Global patterns and trends in the breast cancer incidence and mortality according to sociodemographic indices: an observational study based on the global burden of diseases
title_fullStr Global patterns and trends in the breast cancer incidence and mortality according to sociodemographic indices: an observational study based on the global burden of diseases
title_full_unstemmed Global patterns and trends in the breast cancer incidence and mortality according to sociodemographic indices: an observational study based on the global burden of diseases
title_short Global patterns and trends in the breast cancer incidence and mortality according to sociodemographic indices: an observational study based on the global burden of diseases
title_sort global patterns and trends in the breast cancer incidence and mortality according to sociodemographic indices an observational study based on the global burden of diseases
url https://bmjopen.bmj.com/content/9/10/e028461.full
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