Frontiers in Oncology (Aug 2023)

Burden of breast cancer and attributable risk factors in the North Africa and Middle East region, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019

  • Sina Azadnajafabad,
  • Sahar Saeedi Moghaddam,
  • Sahar Saeedi Moghaddam,
  • Esmaeil Mohammadi,
  • Esmaeil Mohammadi,
  • Negar Rezaei,
  • Negar Rezaei,
  • Mohammad-Mahdi Rashidi,
  • Nazila Rezaei,
  • Ali H. Mokdad,
  • Ali H. Mokdad,
  • Mohsen Naghavi,
  • Mohsen Naghavi,
  • Christopher J. L. Murray,
  • Christopher J. L. Murray,
  • Bagher Larijani,
  • Farshad Farzadfar,
  • Farshad Farzadfar,
  • GBD 2019 NAME Breast Cancer Collaborators,
  • Sina Azadnajafabad,
  • Sahar Saeed Moghaddam,
  • Esmaeil Mohammadi,
  • Negar Rezaei,
  • Mohammad-Mahdi Rashidi,
  • Nazila Rezaei,
  • Mohsen Abbasi-Kangevari,
  • Zeinab Abbasi-Kangevari,,
  • Hedayat Abbastabar,
  • Hassan Abidi,
  • Hassan Abolhassani,
  • Hiwa Abubaker Ali,
  • Eman Abu-Gharbieh,
  • Juan Manuel Acuna,
  • Sima Afrashteh,
  • Muhammad Sohail Afzal,
  • Sajjad Ahmad,
  • Ali Ahmadi,
  • Sepideh Ahmadi,
  • Haroon Ahmed,
  • Luai A. Ahmed,
  • Tarik Ahmed Rashid,
  • Marjan Ajami,
  • Mostafa Akbarzadeh-Khiavi,
  • Hanadi Al Hamad,
  • Mohammed Khaled Al-Hanawi,
  • Beriwan Abdulqadir Ali,
  • Yousef Alimohamadi,
  • Sadaf Alipour,
  • Syed Mohamed Aljunid,
  • Sami Almustanyir,
  • Rajaa M Al-Raddadi,
  • Saba Alvand,
  • Jalal Arabloo,
  • Morteza Arab-Zozani,
  • Armin Aryannejad,
  • Tahira Ashra,
  • Seyyed Shamsadin Athari,
  • Amirhossein Azari Jafari,
  • Nader Bagheri,
  • Sara Bagherieh,
  • Saeed Bahadory,
  • Mohammad Behnammoghadam,
  • Akshaya Srikanth Bhagavathula,
  • Somayeh Bohlouli,
  • Wolfram Manuel Wolfram Brück,
  • Aso Mohammad Darwesh,
  • Mostafa Dianatinasab,
  • Fariba Dorostkar,
  • Ebrahim Eini,
  • Iffat Elbarazi,
  • Muhammed Elhadi,
  • Iman El Sayed,
  • Maysaa El Sayed Zaki,
  • Sharareh Eskandarieh,
  • Ibtihal Fadhil,
  • Fatemeh Farahmand,
  • Pawan Sirwan Faris,
  • Nasrin Galehdar,
  • Mansour Ghafourifard,
  • Seyyed-Hadi Ghamari,
  • Azin Ghamari,
  • Ahmad Ghashghaee,
  • Maryam Gholamalizadeh,
  • Kimiya Gohari,
  • Goleij Goleij,
  • Golitaleb Golitaleb,
  • Mohammed Ibrahim Mohialdeen Gubari,
  • Nima Hafezi-Nejad,
  • Rabih Halwani,
  • Randah R Hamadeh,
  • Samer Hamidi,
  • Asif Hanif,
  • Shafiul Haque,
  • Soheil Hassanipour,
  • Khezar Hayat,
  • Mohammad Heidar,
  • Zahra Heidarymeybodi,
  • Mohammad-Salar Hosseini,
  • Mehdi Hosseinzadeh,
  • Mohamed Hsairi,
  • Elham Jamshidi,
  • Amirreza Javadi Mamaghani,
  • Tahereh Javaheri,
  • Ali Kabir,
  • Leila R Kalankesh,
  • Leila Keikavoosi-Arani,
  • Yousef Saleh Khader,
  • Ejaz Ahmad Khan,
  • Gulfaraz Khan,
  • Maryam Khayamzadeh,
  • Behzad Kiani,
  • Hamid Reza Koohestani,
  • Sang-woong Lee,
  • Mozhgan Letafat-nezhad,
  • Somayeh Livani,
  • Farzan Madadizadeh,
  • Ahmad R Mafi,
  • Soleiman Mahjoub,
  • Ata Mahmoodpoor,
  • Marzieh Mahmoudimanesh,
  • Mohammad-Reza Malekpour,
  • Ahmad Azam Malik,
  • Fariborz Mansour-Ghanaei,
  • Mohammad Ali Mansournia,
  • Seyedeh Zahra Masoumi,
  • Entezar Mehrabi Nasab,
  • Seyyedmohammadsadeq Mirmoeeni,
  • Yousef Mohammad,
  • Karzan Abdulmuhsin Mohammad,
  • Mokhtar Mohammadi,
  • Ari f Mohammed,
  • Sara Momtazmanesh,
  • Abdolvahab Sara,
  • Paula Moraga,
  • Abbas Mosapour,
  • Atta Abbas Naqvi,
  • Zuhair S Natto,
  • Seyed Aria Nejadghaderi,
  • Marzieh Nojomi,
  • Maryam Noori,
  • Hassan Okati-Aliabad,
  • Reza Pakzad,
  • Hamidreza Pazoki Toroudi,
  • Zahra Zahid Piracha,
  • Naeimeh Pourtaheri,
  • Fakher Rahim,
  • Shahram Rahimi-Dehgolan,
  • Amir Masoud Rahmani,
  • Vahid Rahmanian,
  • Mahsa Rashidi,
  • Amirfarzan Rashidi,
  • Reza Rawassizadeh,
  • Mohammad Sadegh Razeghinia,
  • Nima Rezaei,
  • Siamak Sabour,
  • Basema Saddik,
  • Umar Saeed,
  • Maryam Sahebazzamani,
  • Amirhossein Sahebkar,
  • Abdallah M Samy,
  • Muhammad Arif Nadeem Saqib,
  • Brijesh Sathian,
  • Sayed Mohammad Shafiee,
  • Saeed Shahabi,
  • Fariba Shahraki-Sanavi,
  • Masood Ali Shaikh,
  • Ali Sheidaei,
  • Rahim Ali Sheikhi,
  • Reza Shirkoohi,
  • Parnian Shobeiri,
  • Mohammad Sadegh Soltani-Zangbar,
  • Elnaz Tabibian,
  • Majid Taheri,
  • Moslem Taheri Soodejani,
  • Mohamad-Hani Temsah,
  • Amir Tiyuri,
  • Irfan Ullah,
  • Sana Ullah,
  • Sahel Valadan Tahbaz,
  • Rohollah Valizadeh,
  • Bay Vo,
  • Yasir Waheed,
  • Seyed Hossein Yahyazadeh Jabbari,
  • Fereshteh Yazdanpanah,
  • Deniz Yuce,
  • Nazar Zaki,
  • Iman Zare,
  • Mohammad Zoladl,
  • Ali H Mokdad,
  • Mohsen Naghavi,
  • Christopher J L Murray,
  • Bagher Larijani,
  • Farshad Farzadfar

DOI
https://doi.org/10.3389/fonc.2023.1132816
Journal volume & issue
Vol. 13

Abstract

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BackgroundBreast cancer (BC) is the most common cancer in women globally. The North Africa and Middle East (NAME) region is coping hard with the burden of BC. We aimed to present the latest epidemiology of BC and its risk factors in this region.MethodsWe retrieved the data on BC burden and risk factors from the Global Burden of Disease Study 2019 to describe BC status in the 21 countries of the NAME region from 1990 to 2019. We explored BC incidence, prevalence, deaths, disability-adjusted life years (DALYs), and attributable burden to seven risk factors of female BC, namely, alcohol use, diet high in red meat, low physical activity, smoking, secondhand smoke, high body mass index, and high fasting plasma glucose. Decomposition analysis on BC incidence trend was done to find out the contributing factors to this cancer’s growth.ResultsIn 2019, there were 835,576 (95% uncertainty interval: 741,968 to 944,851) female and 10,938 (9,030 to 13,256) male prevalent cases of BC in the NAME region. This number leads to 35,405 (30,676 to 40,571) deaths among female patients and 809 (654 to 1,002) deaths in male patients this year. BC was responsible for 1,222,835 (1,053,073 to 1,411,009) DALYs among female patients in 2019, with a greater proportion (94.9%) of burden in years of life lost (YLLs). The major contributor to female BC incidence increase in the past three decades was found to be increase in age-specific incidence rates of BC (227.5%), compared to population growth (73.8%) and aging (81.8%). The behavioral risk factors were responsible for majority of attributable female BC burden (DALYs: 106,026 [66,614 to 144,247]). High fasting plasma glucose was found to be the risk factor with the largest effect (DALYs: 84,912 [17,377 to 192,838]) on female BC burden.ConclusionThe increasing incidence and burden of BC in the NAME region is remarkable, especially when considering limited resources in the developing countries of this region. Proper policies like expanding screening programs and careful resource management are needed to effectively manage BC burden.

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