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Global, regional, national burden of breast cancer in 185 countries: evidence from GLOBOCAN 2018

  • Epidemiology
  • Published:
Breast Cancer Research and Treatment Aims and scope Submit manuscript

Abstract

Purpose

This study aims to examine the burden of breast cancer in 185 countries in 2018.

Methods

The estimates of incidence, mortality, and prevalence of breast cancer were drawn from GLOBOCAN 2018. The overall burden of breast cancer was gauged using breast cancer burden index (BRCBI)—a novel index comprising age-standardized incidence rate (ASIR), age-standardized mortality rate (ASMR), mortality-to-incidence ratio (MIR), prevalence-to-incidence ratio (PIR), and prevalence-to-mortality ratio (PMR). The socioeconomic status of countries was measured using human development index (HDI)

Results

Globally, breast cancer was responsible for an estimated 626,679 deaths at age-standardized rate of 13/100,000; there were 2.1 million cases diagnosed in 2018 at age-standardized rate of 46.3/100,000. The ASIR varied 22-fold from 5/100,000 (Bhutan) to 113.2/100,000 (Belgium). The ASMR varied 13-fold from 2.7/100,000 (Bhutan) to 36.9/100,000 (Fiji). The HDI exhibited a positive gradient with ASIR (r = 0.73), PIR (r = 0.98), and PMR (r = 0.85); with MIR, however, it exhibited a negative association (r = − 0.83). The BRCBI spanned from 0.70 in Somalia to 78.92 in South Korea and exhibited a positive association with HDI (r = 0.76). An additional 46,823 female lives in 2018 and a cumulative total of 333,304 lives could have been saved over 2013–2018, had countries performed as per their HDI.

Conclusions

The substantial burden of breast cancer in developing and low-resource economies calls for a holistic approach to cancer management and control that includes oncologic infrastructure to provide cost-effective screening, diagnostic, therapeutic, and palliative services, greater breast cancer awareness, and mitigation of risk factors.

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Notes

  1. Choosing minimum values as 1st percentile also helped in not assigning 0 value to BRCBI.

  2. An alternate index using arithmetic mean was generated; it has a pairwise correlation of r = 0.9230 with BRCBI (Supplementary Table S3).

  3. Number of deaths that could be prevented in 2018 was calculated as per the following.

    $$({\text{Extra}}\; {\text{Deaths}})_{2018} = ({\text{Incidence}})_{2018}({\text{Observed}}\; {\text{MIR}}-{\text{Expected}}\; {\text{MIR}})$$

  4. Number of lives saved as per PMR was calculated as per the following.

    $$\left( {{\text{Extra}}\; {\text{Deaths}}} \right)_{2013{-}18} = \left( {{\text{Observed}} \;{\text{Deaths}}} \right)_{2018} \left( {{\text{Observed}}\; {\text{PMR }}- {\text{Expected}}\; {\text{PMR}}} \right)$$

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  1. University School of Management and Entrepreneurship, Delhi Technological University, Delhi, India

    Rajesh Sharma

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Sharma, R. Global, regional, national burden of breast cancer in 185 countries: evidence from GLOBOCAN 2018. Breast Cancer Res Treat 187, 557–567 (2021). https://doi.org/10.1007/s10549-020-06083-6

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