The global and regional burden of breast cancer in females from 1990-2023: A systematic analysis for the Global Burden of Disease study 2023.

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e22575 Background: Breast cancer is one of the most common cancers globally with approximately one in eight females developing breast cancer in their lifetime. Despite advances in breast cancer diagnostics and treatment, it remains the most common cancer causing death in females and stark geographic disparities in outcomes remain. This study provides an update on the global burden of breast cancer from 1990-2023, highlighting differences by income group to support collective efforts to address these inequities. Methods: As part of the Global Burden of Disease Study (GBD) 2023, we estimated breast cancer incidence, mortality, and disability-adjusted life years (DALYs) from 1990-2023 globally, regionally, and by World Bank income group (WBIG). Counts and age-standardized rates were generated using data from population-based cancer registries, vital registration systems, and verbal autopsies. Mortality was estimated using ensemble models which were then transformed to incidence through modeled ratios of mortality to incidence. 95% uncertainty intervals (UIs) were computed as the 2.5th and 97.5th percentiles of the distribution across 250 draws. Results: In 2023, breast cancer was one of the most common cancers occurring among females globally and there were more deaths from breast cancer than any other cancer in females. Although breast cancer cases and deaths increased between 1990 and 2023 globally, trends in age-standardized mortality rates (ASMRs) varied drastically by WBIG. Between 1990 and 2023, there was a decline in ASMRs in the high WBIG while there was a substantial increase in the low- and lower-middle WBIGs. The largest regional increase in ASMRs between these years occurred in the Sub-Saharan Africa GBD super region. In addition to the rising ASMRs in lower WBIGs, these income groups also experienced the greatest increases in age-standardized incidence rates (ASIRs). Conclusions: The GBD 2023 estimates provide a comprehensive summary of breast cancer burden over time. Although ASMRs are declining in the high WBIG, regional inequities persist, with increasing ASIRs and ASMRs in lower income WBIGs. Initiatives aimed at earlier detection and improved access to quality care represent approaches to reducing the disparities present today and improving outcomes for individuals withbreast cancer around the world.

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