Abstract Background Breast cancer (BC) has become the most common malignancy worldwide. Our aim was to assess the global diversity of disability due to breast cancer in 204 countries and territories. Methods Using data from the Global Burden of Disease (GBD) 2021 study the diversity of disability due to breast cancer was estimated for 204 countries and territories, and breast cancer incidence, prevalence, mortality, and Years Lived with Disability (YLDs) were further assessed. Absolute number, rate, and age standardized rate with 95% uncertainty intervals (UIs) were used to compare the difference. Data analysis was further stratified by the socio-demographic index (SDI) of the regions, average annual percentage changes (AAPC) and trends were analyzed by the Joinpoint regression procedure. Results From 1990 to 2021, the global disability-adjusted life years (DALYs) caused by breast cancer showed a trend of first decrease and then increase in 204 countries, especially during the epidemic period of Corona Virus Disease 2019 (COVID-19) from 2019 to 2021, with 63% of countries experiencing an increase in DALYs for three consecutive years, mainly in Africa. During this period, there was a significant increase trend in DALYs caused by breast cancer in low - and middle-income countries, with Turkey having the highest growth rate. High-income countries showed declines, with Denmark, Luxembourg and the United Kingdom experiencing declines of more than 50%. For males, the highest incidence, prevalence, mortality, and DALYs are mainly concentrated in the Eastern Sub-Saharan Africa region. For females, high incidence and prevalence are found in economically developed regions such as Europe and North America, while the highest mortality and DALYs are primarily concentrated in the Oceania region. The DALYs of breast cancer patients in the 15–49 years age group are highest in low-middle SDI countries, approximately 180.86 per 100,000 (95% UI:161.08, 201.32). For the 50–74 years age group, the highest DALYs are found in low SDI countries, about 754.47 per 100,000 (95% UI: ). In the ≥ 75 years age group, the highest DALYs are observed in high SDI countries, approximately 1166.46 per 100,000 (95% UI:952.49, 1296.24). Overall, DALYs showed a slight global increase from 2012 to 2021 but a decrease over the 30-year span from 1990 to 2021. Conclusions From 1990 to 2021, DALYs due to breast cancer worldwide decreased first and then increased, especially during the COVID-19 pandemic. There is a significant increase in breast cancer DALYs in low - and middle-income countries, while there is a downward trend in high-income countries. In addition, there is a complex relationship between breast cancer indicators and socio-demographic index (SDI) in different countries and regions, indicating the importance of considering multiple factors when analyzing cancer epidemiology and the need to tailor cancer prevention and treatment approaches based on local context and social characteristics.
Zhu et al. (Sat,) studied this question.