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Breast cancer incidence, mortality and mortality-to-incidence ratio (MIR) are associated with human development, 1990–2016: evidence from Global Burden of Disease Study 2016

Abstract

Objective

To examine breast cancer burden in females using incidence, mortality and mortality-to-incidence ratio (MIR) and its association with human development.

Methods

We employ the data of breast cancer in females from the Global Burden of Disease 2016 study for the period 1990 to 2016 for 102 countries. Human development is measured using the human development index (HDI). 5-year survival rate of breast cancer is proxied using the mortality-to-incidence ratio (MIR).

Findings

Globally, breast cancer has claimed 535341 female lives and 1.7 million incident cases had surfaced in 2016. High incidence rates were observed in very high HDI countries led by the Netherlands (117.2/100,000), whereas the mortality rate was high in low/medium HDI countries led by Afghanistan (35.4/100,000). Breast cancer incidence has more than doubled in 60/102 countries, whereas deaths have doubled in 43/102 countries. Globally, breast cancer MIR decreased from 0.41 to 0.32 over 1990–2016 and displayed negative gradient with HDI (r = − 0.87), indicating a low 5-year survival in less developed countries.

Conclusion

Heterogeneity in breast cancer burden, as per human development, and increasing breast cancer incidence and low survival rates, indicated by MIR, call for broader human development, improving breast cancer awareness, and cost-effective screening and treatment in less developed countries.

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Fig. 1

Data source: MIR was calculated by the author using crude mortality and incidence data of female breast cancer from the GBD 2016 study, and HDI data (and its components) was procured from the UNDP database

Fig. 2
Fig. 3
Fig. 4

Data source: MIR is calculated by the author using crude mortality and incidence data, HDI data is procured from the UNDP database and UHC data is procured from the WDI database of World Bank which in turn was compiled from Hogan et al. [30]. OOP data is also from the WDI database of World Bank

Notes

  1. 1000 cases are chosen so as to exclude countries with too few cancer cases as it may lead to too large or too small MIR values which may not truly reflect countries’ development status and may distort main conclusions of the paper.

  2. Country-specific HDI values and component-wise values in 2015 are presented in Table 3 of the “Appendix”.

  3. Annual percentage change of incidence, mortality, ASIR, ASMR and MIR over the period 1990 to 2016 for different HDI groupings is shown in Fig. 5 of the “Appendix”.

  4. National Cancer Screening Program in Georgia also one of the successful screening program which resulted in downstaging of breast cancer and improved survival rate. Source: http://www.gnsc.ge/?act=page&id=44&lang=en (Accessed 18 Oct 2018).

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Correspondence to Rajesh Sharma.

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Appendix

Appendix

See Figs. 5 and 6 and Tables 2 and 3.

Fig. 5
figure 5

HDI groupwise annual percentage change of breast cancer burden, 1990–2016. ASIR age-standardised incidence rate, ASMR age-standardised mortality rate, MIR mortality-to-incidence ratio. Countries were categorised into four groups as per HDI value in 2015: very high (HDI > 0.800), high (0.700 < HDI < 0.799), medium (0.550 < HDI < 0.669) and low (HDI < 0.550)

Fig. 6
figure 6

HDI category-wise temporal movement of mortality-to-incidence ratio (MIR), 1990–2016. Data pertains to aggregate of data for low HDI (15) countries, medium HDI (18) countries, high HDI (31) countries and very high HDI (36) countries for the period 1990 to 2016 and is procured from Global Burden of Disease study 2016. Countries were categorised into four groups as per HDI value in 2015: very high (HDI > 0.800), high (0.700 < HDI < 0.799), medium (0.550 < HDI < 0.669) and low (HDI < 0.550)

Table 2 Total percentage change and annual percentage change (APC) of mortality, incidence, ASIR, ASMR and MIR of all countries over 1990–2016
Table 3 Country-wise human development index and its components in 2015

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Sharma, R. Breast cancer incidence, mortality and mortality-to-incidence ratio (MIR) are associated with human development, 1990–2016: evidence from Global Burden of Disease Study 2016. Breast Cancer 26, 428–445 (2019). https://doi.org/10.1007/s12282-018-00941-4

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Keywords

  • Breast cancer
  • Incidence
  • Mortality
  • Mortality-to-incidence ratio (MIR)