Abstract P3-05-05: A Comprehensive Study of Breast Cancer Mortality and DALY Trends considering Smoking as a Risk Factor from 1991-2021 in the USA and exploring the State-level disparities

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Abstract Introduction: Breast cancer is the second leading cause of cancer death in women. Smoking has been considered an important risk factor. Over the past 25 years, intensive screening strategies have been implemented to detect breast cancer early. Numerous legislative acts have also been passed to prohibit smoking and public tobacco use. In this study we highlight the trends in breast cancer mortality and disability adjusted life years (DALY) using tobacco as a risk factor with a focus on sex and state wise disparities. Method: Data on Age-standardized death rates and Disability-Adjusted Life Years (DALY) for breast cancer with smoking as a risk factor were extracted from Global Burden of Disease database. Information about males and females across all U.S. states from 1991 to 2021 were studied. To evaluate performance, the percentage decline in mortality and DALY for every state was computed from 1991 to 2021 and compared to the overall trend in the US. Joinpoint regression analysis was used to examine gender and temporal trends in the US. Results: Mortality rates in the US decreased by 55.1% from 1991 to 2021. Within the States, the largest reduction was seen in the state of Massachusetts (71.05%) and least decrease was observed in Mississippi (31.89%). On sub-group analysis based on sex, mortality decreased by 51.4% for females and 46.2% for males in the US. Within the States, Massachusetts had the most significant decrease in breast cancer mortality associated with smoking tobacco in females (70.7%) Mississippi had the lowest reduction for both at 30.25% for females and 22.3% in males. In the US, DALY rates decreased by 57.42% overall, with a more significant decrease in females (56.79%) than in males (46.03%). On state-specific trends, some of the notable decrease were seen in Massachusetts (73.61%), California (65.06%) , New York (66.7%), Maryland (62.06%) and Connecticut (64.96%) from 1991 to 2021. In terms of sex specific data, Massachusetts has shown the greatest reduction in DALY among females (73.4%) and males (61.45%). Lowest reduction in DALY was seen in West Virginia (30.8%) in females and Mississippi (19.53%) in males. Conclusions: The results indicate a notable decrease in mortality and DALY related to tobacco-associated breast cancer. This is likely due to improved screening strategies and treatment options. These findings also underscore the advances in the breast cancer landscape. However, substantial state-level disparities remain, emphasizing the need for further epidemiological studies to identify and address the underlying factors. Citation Format: Vaibhavi Mukhtiar, Charmi Bhanushali, Ronit Juthani, Raj Shah, Mansi Mehta, Devang Namjoshi, Navya Perkit Reddy. A Comprehensive Study of Breast Cancer Mortality and DALY Trends considering Smoking as a Risk Factor from 1991-2021 in the USA and exploring the State-level disparities [abstract]. In: Proceedings of the San Antonio Breast Cancer Symposium 2024; 2024 Dec 10-13; San Antonio, TX. Philadelphia (PA): AACR; Clin Cancer Res 2025;31(12 Suppl):Abstract nr P3-05-05.

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