Global Disease Burden Of Female Breast Cancer And It’s Correlation With Human Development Index And Health System Attainment

Background:Breast cancer is the leading cause of death among female cancers, with one in 18 women developing breast cancer between birth and age 79 years. The epidemics of breast cancer vary widely worldwide. This study aimed to show the global disease burden of female breast cancer, and to analysis the time trends of incidence and mortality across the world. We also clarified the relationship between the national socioeconomic development assessed according to the global Human Development Index (HDI), the attainment of each country’s health care system and the outcomes of female breast cancer, evaluated by mortality-to-incidence ratio (MIR).Methods:We extracted global female breast cancer data as originally reported in the Global Burden of Disease 2013 database, Cancer Incidence in Five Continents Time Trend, CI5plus database and GLOBOCAN 2012 database. The worldwide population data of 1990 to 2013 were obtained from the World Health Organization (WHO) database. The HDIs of 187 Union Nation members in 2012 and 2014 were obtained from United Nations Development Programme database, according to Human Development Report 2013 and 2015. The data of health system attainment from 191 member countries were obtained from the WHO World Health Report 2000. We then performed Joinpoint regression analyses to estimate the time trends of breast cancer incidence and mortality. Correlation analyses, liner regression analyses, quantile regression analyses and One-way ANOVA analyses were used to calculate the effects of HDI and health system attainment on breast cancer MIR.Results:Our results demonstrated that the disease burden of female breast cancer differs from country to country. The rates of incidence, mortality and disability-adjusted life year (DALY) are much higher in Americas and European region than those in South-east Asia, African and Eastern Mediterranean regions. The overall time trends of female breast cancer incidence rates increased from 1980 to 2007. Rates in developed countries, as United States, New Zealand and United Kingdom, peaked in late 1990s and became stable or declined thereafter, especially in women aged 50 to 69 years old. While in Asia and Africa, the rates greatly raised in all age groups. The overall time trends of female breast cancer death rates decreased since 1990. Mortality in countries with very high HDIs acquired significant declines in female patients younger than 75 years old, and developed countries with higher incidence rates always achieved lower MIRs. However, the mortality of elder patients was still high across the world, even in high-income nations. By the year 2013, patients more than 70 years old have occupied half of all breast cancer deaths in very high HDI countries. Though the incidence and death rates were low in developing countries, the MIRs were much worse in these low-income nations, and the proportion of young patients was still increasing.Conclusion:With the prevalence of breast cancer screening programs and the progress in cancer treatment, the prognosis of female breast cancer patients has improved substantially. There is still notable discrepancy in breast cancer between high- and low-income countries. The epidemic time trends also varied, indicating critical roles played by socioeconomic development and health system attainment. Countries, especially transitioning ones, should be continually dedicated in implementing cost-effective control programs and improving access to breast cancer treatment.