Disease burden and attributable risk factors of breast cancer in Chinese females from 1990 to 2019_Chinese Journal of Evidence-Based Medicine

Authors：

LI Yizhen ^1,2 , ZHENG Yi ^1,2 , DENG Yujiao ^1,2 , WU Ying ^1,2 , YANG Si ^1,2 ,  DAI Zhijun ^1,2

1. Department of Breast Surgery, Zhejiang University School of Medicine First Affiliated Hospital, Hangzhou 310006, P.R.China;
2. Department of Oncology, Xi’an Jiaotong University Second Affiliated Hospital, Xi’an 710004, P.R.China;

Corresponding author：

DAI Zhijun, Email: dzj0911@126.com

Keywords：

Breast cancer; Global burden of disease; Joinpoint regression analysis; Body mass index; Diet high in red meat

DOI：

10.7507/1672-2531.202103139

Video：

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Abstract Full text Figures/Tables Video References Cited by

Objective To analyze the latest epidemiological status of breast cancer in China, trends in morbidity and mortality from 1990 to 2019, and related prognostic risk factors.Methods Data on incidence and mortality of Chinese female breast cancer, their related age-standardized rates (ASRs) from 1990 to 2019, and attributable risk factors were obtained from the Global Burden of Disease (GBD) database, and data on disability-adjusted life years (DALYs) of 34 provinces in China were obtained from literature. Joinpoint regression analysis was used to analyze the trends of ASRs. The exposure levels of each attributable risk factor and the increased cancer burden were analyzed.Results The incidence of breast cancer in Chinese females increased annually, from 17.07/100 000 in 1990 to 35.61/100 000 in 2019, while the mortality rate initially increased and decreased, and then exhibited an upward trend after 2016 and there was no obvious variation from 1990 (9.16/100 000) to 2019 (9.02/100 000). Among the 34 provinces of China, Shandong Province had the most serious breast cancer burden, while Macao Special Administrative Region had the lowest. Among the seven prognostic risk factors, high body mass index (BMI) contributed the most to the breast cancer burden and the exposure risk of a diet high in red meat had shown a significant increasing trend in the past 30 years. Therefore, the disease burden caused by a high red meat diet would be increasing.Conclusions The incidence rate of breast cancer in Chinese females is increasing. With the development of social economy and the change of people’s dietary habits, the breast cancer burden in China trends to become heavier and heavier. Therefore, it is necessary to conduct the "three early" prevention and treatment and advocate healthy and reasonable diet and living habits to reduce the burden of breast cancer to improve prognosis and quality of life.

Citation： LI Yizhen, ZHENG Yi, DENG Yujiao, WU Ying, YANG Si, DAI Zhijun. Disease burden and attributable risk factors of breast cancer in Chinese females from 1990 to 2019. Chinese Journal of Evidence-Based Medicine, 2021, 21(8): 876-881. doi: 10.7507/1672-2531.202103139 Copy

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13.	Suzuki Y, Tsunoda H, Kimura T, et al. BMI change and abdominal circumference are risk factors for breast cancer, even in Asian women. Breast Cancer Res Treat, 2017, 166(3): 919-925.
14.	His M, Le Guélennec M, Mesrine S, et al. Life course evolution of body size and breast cancer survival in the E3N cohort. Int J Cancer, 2018, 142(8): 1542-1553.
15.	Oudanonh T, Nabi H, Ennour-Idrissi K, et al. Progesterone receptor status modifies the association between body mass index and prognosis in women diagnosed with estrogen receptor positive breast cancer. Int J Cancer, 2020, 146(10): 2736-2745.
16.	Heng YJ, Wang J, Ahearn TU, et al. Molecular mechanisms linking high body mass index to breast cancer etiology in post-menopausal breast tumor and tumor-adjacent tissues. Breast Cancer Res Treat, 2019, 173(3): 667-677.
17.	Carreras G, Lachi A, Boffi R, et al. Burden of disease from breast cancer attributable to smoking and second-hand smoke exposure in Europe. Int J Cancer, 2020, 147(9): 2387-2393.
18.	Bhatta DN, Hiatt RA, Van Loon K, et al. Exposure to household tobacco smoke and risk of cancer morbidity and mortality: analysis of data from the Afghanistan Demographic and Health Survey 2015. Prev Med, 2019, 123: 217-224.
19.	Hanaoka T, Yamamoto S, Sobue T, et al. Active and passive smoking and breast cancer risk in middle-aged Japanese women. Int J Cancer, 2005, 114(2): 317-322.
20.	Lin Y, Kikuchi S, Tamakoshi K, et al. Active smoking, passive smoking, and breast cancer risk: findings from the Japan Collaborative Cohort Study for evaluation of cancer risk. J Epidemiol, 2008, 18(2): 77-83.
21.	World Health Organization. Q&A on the carcinogen-icity of the consumption of red meat and processedmeat. Available at: https://www.iarc.who.int/wp-content/uploads/2018/07/Monographs-QA_Vol114.pdf.
22.	Wolk A. Potential health hazards of eating red meat. J Intern Med, 2017, 281(2): 106-122.
23.	Vrieling A, Buck K, Seibold P, et al. Dietary patterns and survival in German postmenopausal breast cancer survivors. Br J Cancer, 2013, 108(1): 188-192.
24.	De Cicco P, Catani MV, Gasperi V, et al. Nutrition and breast cancer: a literature review on prevention, treatment and recurrence. Nutrients, 2019, 11(7): 1514.
25.	Lauber SN, Ali S, Gooderham NJ. The cooked food derived carcinogen 2-amino-1-methyl-6-phenylimidazo[4,5-b] pyridine is a potent oestrogen: a mechanistic basis for its tissue-specific carcinogenicity. Carcinogenesis, 2004, 25(12): 2509-2517.
26.	Binnie MA, Barlow K, Johnson V, et al. Red meats: time for a paradigm shift in dietary advice. Meat Sci, 2014, 98(3): 445-451.

1. GBD 2019 Diseases and Injuries Collaborators. Global burden of 369 diseases and injuries in 204 countries and territories, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet, 2020, 396(10258): 1204-1222.
2. GBD 2017 Disease and Injury Incidence and Prevalence Collaborators. Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet, 2018, 392(10159): 1789-1858.
3. Ding Y, Chen X, Zhang Q, et al. Historical trends in breast cancer among women in China from age-period-cohort modeling of the 1990-2015 breast cancer mortality data. BMC Public Health, 2020, 20(1): 1280.
4. Youlden DR, Cramb SM, Dunn NA, et al. The descriptive epidemiology of female breast cancer: an international comparison of screening, incidence, survival and mortality. Cancer Epidemiol, 2012, 36(3): 237-248.
5. Heer E, Harper A, Escandor N, et al. Global burden and trends in premenopausal and postmenopausal breast cancer: a population-based study. Lancet Glob Health, 2020, 8(8): e1027-e1037.
6. 曾倩, 崔芳芳, 宇传华, 等. 中国癌症发病, 死亡现状与趋势分析. 中国卫生统计, 2016, 33(2): 321-323.
7. Tastula A, Jukkola A, Alakokkare AE, et al. Early-life risk factors for breast cancer - prospective follow-up in the Northern Finland Birth Cohort 1966. Cancer Epidemiol Biomarkers Prev, 2021, 30(4): 616-622.
8. Zhou M, Wang H, Zeng X, et al. Mortality, morbidity, and risk factors in China and its provinces, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet, 2019, 394(10204): 1145-1158.
9. Li N, Zhai Z, Zheng Y, et al. Association of 13 occupational carcinogens in patients with cancer, individually and collectively, 1990-2017. JAMA Netw Open, 2021, 4(2): e2037530.
10. Kim HJ, Fay MP, Feuer EJ, et al. Permutation tests for joinpoint regression with applications to cancer rates. Stat Med, 2000, 19(3): 335-351.
11. Armstrong RA. When to use the Bonferroni correction. Ophthalmic Physiol Opt, 2014, 34(5): 502-508.
12. Geiss LS, Wang J, Cheng YJ, et al. Prevalence and incidence trends for diagnosed diabetes among adults aged 20 to 79 years, United States, 1980-2012. JAMA, 2014, 312(12): 1218-1226.
13. Suzuki Y, Tsunoda H, Kimura T, et al. BMI change and abdominal circumference are risk factors for breast cancer, even in Asian women. Breast Cancer Res Treat, 2017, 166(3): 919-925.
14. His M, Le Guélennec M, Mesrine S, et al. Life course evolution of body size and breast cancer survival in the E3N cohort. Int J Cancer, 2018, 142(8): 1542-1553.
15. Oudanonh T, Nabi H, Ennour-Idrissi K, et al. Progesterone receptor status modifies the association between body mass index and prognosis in women diagnosed with estrogen receptor positive breast cancer. Int J Cancer, 2020, 146(10): 2736-2745.
16. Heng YJ, Wang J, Ahearn TU, et al. Molecular mechanisms linking high body mass index to breast cancer etiology in post-menopausal breast tumor and tumor-adjacent tissues. Breast Cancer Res Treat, 2019, 173(3): 667-677.
17. Carreras G, Lachi A, Boffi R, et al. Burden of disease from breast cancer attributable to smoking and second-hand smoke exposure in Europe. Int J Cancer, 2020, 147(9): 2387-2393.
18. Bhatta DN, Hiatt RA, Van Loon K, et al. Exposure to household tobacco smoke and risk of cancer morbidity and mortality: analysis of data from the Afghanistan Demographic and Health Survey 2015. Prev Med, 2019, 123: 217-224.
19. Hanaoka T, Yamamoto S, Sobue T, et al. Active and passive smoking and breast cancer risk in middle-aged Japanese women. Int J Cancer, 2005, 114(2): 317-322.
20. Lin Y, Kikuchi S, Tamakoshi K, et al. Active smoking, passive smoking, and breast cancer risk: findings from the Japan Collaborative Cohort Study for evaluation of cancer risk. J Epidemiol, 2008, 18(2): 77-83.
21. World Health Organization. Q&A on the carcinogen-icity of the consumption of red meat and processedmeat. Available at: https://www.iarc.who.int/wp-content/uploads/2018/07/Monographs-QA_Vol114.pdf.
22. Wolk A. Potential health hazards of eating red meat. J Intern Med, 2017, 281(2): 106-122.
23. Vrieling A, Buck K, Seibold P, et al. Dietary patterns and survival in German postmenopausal breast cancer survivors. Br J Cancer, 2013, 108(1): 188-192.
24. De Cicco P, Catani MV, Gasperi V, et al. Nutrition and breast cancer: a literature review on prevention, treatment and recurrence. Nutrients, 2019, 11(7): 1514.
25. Lauber SN, Ali S, Gooderham NJ. The cooked food derived carcinogen 2-amino-1-methyl-6-phenylimidazo[4,5-b] pyridine is a potent oestrogen: a mechanistic basis for its tissue-specific carcinogenicity. Carcinogenesis, 2004, 25(12): 2509-2517.
26. Binnie MA, Barlow K, Johnson V, et al. Red meats: time for a paradigm shift in dietary advice. Meat Sci, 2014, 98(3): 445-451.

Chinese Journal of Evidence-Based Medicine

Disease burden and attributable risk factors of breast cancer in Chinese females from 1990 to 2019

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