Behavioral risk-attributable global breast cancer deaths declined from 1990 to 2023 (EAPC -1.06%), whereas metabolic risk-attributable deaths remained stable (EAPC -0.27%).
Observational
Yes
The global burden of breast cancer attributable to behavioral risks has declined over 34 years, whereas the burden from metabolic risks has remained stable or increased, particularly in younger adults.
e12765 Background: Breast cancer (BC) remains one of the most common malignancies globally and a leading cause of female mortality and disability. Although advancements in screening and treatment have improved outcomes in high- income countries, the burden attributable to modifiable risk factors—particularly behavioral risks (BRs) and metabolic risks (MRs) varies substantially over time, regions, and socio-demographic strata. Methods: We utilized the Global Burden of Disease (GBD) 2023 framework to quantify global, regional, and age-specific BC burden attributable to BRs and MRs across 204 countries from 1990 to 2023. Outcomes included deaths, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life years (DALYs). Results: Globally, BC deaths attributable to all risk factors increased from 120,728 (95% UI: 71,625–165,691) in 1990 to 232,506 (133,617–322,736) in 2023 (EAPC +1.81%). YLLs rose from 3.55 to 6.43 million (+1.58%), and YLDs from 226,705 to 509,110 (+2.38%). Age-standardized mortality rates (ASMRs) declined in HI (−1.61%), High-Socio-demographic Index (SDI) (−1.51%), SEA, EA, and Oceania (−0.66%), High-middle SDI (−0.50%), and CE, EE and CA (−0.37%); remained stable in Low SDI (−0.17%); and increased in SA (+1.84%), NEMA (+1.21%), SA (+1.01%), Low-middle SDI (+0.61%), Middle SDI (+0.55%), and LA and Caribbean (+0.16%). From 1990-2023, BC burden attributable to BRs declined across all metrics: Deaths (EAPC −1.06%), DALYs (−0.97%), YLLs (−1.02%), and YLDs (−0.34%). Conversely, MR-attributable burden remained stable or slightly increased: Deaths (−0.27%), YLLs (−0.26%), YLDs (+0.41%). Age-stratified analysis showed that BR- attributable DALY rates declined in: 20–54 years (−0.35%), and ≥55 years (−1.04%). In contrast, MR- attributable DALY rates increased in 20–54 years (+0.88%) and slightly declined in ≥55 years (−0.16%). Conclusions: The global burden of BC attributable to BRs consistently declined, while that due to MRs remained stable or rose—particularly among younger and middle-aged adults. These findings highlight the shifting landscape of modifiable exposures and underscore the urgent need for targeted MR reduction strategies, especially in low- and middle-income countries (LMICs) where BC mortality is on the rise. Region Diet high in red meat High alcohol use High body-mass index High fasting plasma glucose Low physical activity Secondhand smoke Smoking High-income (HI) -1.59 -1.86 -0.99 -0.9 -1.44 -3.14 -2.26 Latin America (LA) and Caribbean 0.31 0.92 1.46 0.44 0.45 -1.83 -1.79 North Africa and Middle East (NEMA) 1.08 -2.4 2.83 2.83 1.39 0.86 0.19 South Asia (SA) 2 0.46 5.56 2.64 1.55 0.35 0.29 Southeast Asia (SEA), East Asia (EA), and Oceania -0.62 -1.18 0.98 -1.04 -0.2 -0.95 -2.05 Sub-Saharan Africa (SA) 1.8 1.71 3.54 2.99 1.94 1.01 0.17 Central Europe (CE), Eastern Europe (EE), and Central Asia (CA) -0.85 -1.02 0.5 0.29 -0.34 -1.94 -0.36
Dekhne et al. (Thu,) conducted a observational in Breast cancer. Behavioral and metabolic risk factors was evaluated on Breast cancer deaths, YLLs, YLDs, and DALYs. Behavioral risk-attributable global breast cancer deaths declined from 1990 to 2023 (EAPC -1.06%), whereas metabolic risk-attributable deaths remained stable (EAPC -0.27%).