Analysis of Disease Burden and Attributable Risk Factors of Early-onset Female Breast Cancer in China and Globally from 1990 to 2021

Danqi HUANG; Min YANG; Wei XIONG; Jingyi LIU; Wanqing CHEN; Jingbo ZHAI; Jiang LI

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Analysis of Disease Burden and Attributable Risk Factors of Early-onset Female Breast Cancer in China and Globally from 1990 to 2021

VernacularTitle:1990—2021年中国与全球早发女性乳腺癌的疾病负担和归因风险因素分析
Author: Danqi HUANG ¹ ; Min YANG ² ; Wei XIONG ³ ; Jingyi LIU ¹ ; Wanqing CHEN ¹ ; Jingbo ZHAI ⁴ ; Jiang LI ¹
Author Information

1. Office for Cancer Screening, National Cancer Center & National Clinical Research Center for Cancer & Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100021, China
2. Department of Comprehensive Intervention, National Cancer Center & National Clinical Research Center for Cancer & Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100021, China
3. Department of Gynecology Endocrine & Reproductive Center, National Clinical Research Center for Obstetric & Gynecologic Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
4. School of Public Health, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China
Publication Type:Journal Article
Keywords: early-onset female breast cancer; disease burden; attributable risk factors; China; global
From: Medical Journal of Peking Union Medical College Hospital 2025;16(3):777-784
CountryChina
Language:Chinese
Abstract: Objective
To analyze the disease burden, temporal trends, and attributable risk factors of early-onset female breast cancer (EOBC) in China and globally from 1990 to 2021.
Methods
Data on the absolute numbers and crude rates of incidence, mortality, and disability-adjusted life years (DALYs) for EOBC (diagnosis age < 50 years) in China and globally were extracted from the Global Burden of Disease (GBD) 2021 database. Attributable DALY proportions for five risk factors (smoking, alcohol use, physical inactivity, high red meat consumption, elevated fasting plasma glucose) and all combined risk factors were obtained. Joinpoint regression analysis was performed to assess temporal trends in age-standardized rates, quantified by annual percentage change (APC) and average annual percentage change (AAPC).
Results
From 1990 to 2021, age-standardized incidence rates of EOBC increased significantly in both China (AAPC=2.25%) and globally (AAPC=0.64%; pairwise comparison, P < 0.001). In contrast, age-standardized mortality rates (China: AAPC=-0.82%; global: AAPC=-0.26%; P < 0.001) and DALY rates (China: AAPC=-0.63%; global: AAPC=-0.18%; P=0.004) showed overall declines. In 2021, China's age-standardized incidence and mortality rates were 13.49 and 1.99 per 100 000, respectively, compared to global rates of 13.61 and 3.14 per 100, 000. Notably, China's age-standardized mortality (APC=0.78% since 2014) and DALY rates (APC=1.38% since 2015) exhibited gradual upward trends in recent years. High red meat consumption accounted for the highest proportion of attributable DALYs for EOBC in both China (13.55%) and globally (11.20%) in 2021.
Conclusions
China's age-standardized EOBC incidence is rising rapidly and approaching global levels, while mortality and DALY rates have increased over the past decade, underscoring persistent challenges in disease control. Future efforts should prioritize expanding the coverage of breast cancer screening programs, optimizing screening protocols, and enhancing public awareness of cancer prevention to mitigate the growing burden of EOBC in China.