AUTHOR=Azadnajafabad Sina , Saeedi Moghaddam Sahar , Mohammadi Esmaeil , Rezaei Negar , Rashidi Mohammad-Mahdi , Rezaei Nazila , Mokdad Ali H. , Naghavi Mohsen , Murray Christopher J. L. , Larijani Bagher , Farzadfar Farshad , GBD 2019 NAME Breast Cancer Collaborators , Azadnajafabad Sina , Moghaddam Sahar Saeed , Mohammadi Esmaeil , Rezaei Negar , Rashidi Mohammad-Mahdi , Rezaei Nazila , Abbasi-Kangevari Mohsen , Abbasi-Kangevari, Zeinab , Abbastabar Hedayat , Abidi Hassan , Abolhassani Hassan , Ali Hiwa Abubaker , Abu-Gharbieh Eman , Acuna Juan Manuel , Afrashteh Sima , Afzal Muhammad Sohail , Ahmad Sajjad , Ahmadi Ali , Ahmadi Sepideh , Ahmed Haroon , Ahmed Luai A. , Rashid Tarik Ahmed , Ajami Marjan , Akbarzadeh-Khiavi Mostafa , Al Hamad Hanadi , Khaled Al-Hanawi Mohammed , Ali Beriwan Abdulqadir , Alimohamadi Yousef , Alipour Sadaf , Aljunid Syed Mohamed , Almustanyir Sami , Al-Raddadi Rajaa M , Alvand Saba , Arabloo Jalal , Arab-Zozani Morteza , Aryannejad Armin , Ashra Tahira , Athari Seyyed Shamsadin , Jafari Amirhossein Azari , Bagheri Nader , Bagherieh Sara , Bahadory Saeed , Behnammoghadam Mohammad , Bhagavathula Akshaya Srikanth , Bohlouli Somayeh , Brück Wolfram Manuel Wolfram , Darwesh Aso Mohammad , Dianatinasab Mostafa , Dorostkar Fariba , Eini Ebrahim , Elbarazi Iffat , Elhadi Muhammed , El Sayed Iman , El Sayed Zaki Maysaa , Eskandarieh Sharareh , Fadhil Ibtihal , Farahmand Fatemeh , Faris Pawan Sirwan , Galehdar Nasrin , Ghafourifard Mansour , Ghamari Seyyed-Hadi , Ghamari Azin , Ghashghaee Ahmad , Gholamalizadeh Maryam , Gohari Kimiya , Goleij Goleij , Golitaleb Golitaleb , Mohialdeen Gubari Mohammed Ibrahim , Hafezi-Nejad Nima , Halwani Rabih , Hamadeh Randah R , Hamidi Samer , Hanif Asif , Haque Shafiul , Hassanipour Soheil , Hayat Khezar , Heidar Mohammad , Heidarymeybodi Zahra , Hosseini Mohammad-Salar , Hosseinzadeh Mehdi , Hsairi Mohamed , Jamshidi Elham , Mamaghani Amirreza Javadi , Javaheri Tahereh , Kabir Ali , Kalankesh Leila R , Keikavoosi-Arani Leila , Saleh Khader Yousef , Khan Ejaz Ahmad , Khan Gulfaraz , Khayamzadeh Maryam , Kiani Behzad , Koohestani Hamid Reza , Lee Sang-woong , Letafat-nezhad Mozhgan , Livani Somayeh , Madadizadeh Farzan , Mafi Ahmad R , Mahjoub Soleiman , Mahmoodpoor Ata , Mahmoudimanesh Marzieh , Malekpour Mohammad-Reza , Malik Ahmad Azam , Mansour-Ghanaei Fariborz , Mansournia Mohammad Ali , Masoumi Seyedeh Zahra , Nasab Entezar Mehrabi , Mirmoeeni Seyyedmohammadsadeq , Mohammad Yousef , Mohammad Karzan Abdulmuhsin , Mohammadi Mokhtar , Mohammed Ari f , Momtazmanesh Sara , Sara Abdolvahab , Moraga Paula , Mosapour Abbas , Naqvi Atta Abbas , Natto Zuhair S , Nejadghaderi Seyed Aria , Nojomi Marzieh , Noori Maryam , Okati-Aliabad Hassan , Pakzad Reza , Toroudi Hamidreza Pazoki , Piracha Zahra Zahid , Pourtaheri Naeimeh , Rahim Fakher , Rahimi-Dehgolan Shahram , Rahmani Amir Masoud , Rahmanian Vahid , Rashidi Mahsa , Rashidi Amirfarzan , Rawassizadeh Reza , Razeghinia Mohammad Sadegh , Rezaei Nima , Sabour Siamak , Saddik Basema , Saeed Umar , Sahebazzamani Maryam , Sahebkar Amirhossein , Samy Abdallah M , Saqib Muhammad Arif Nadeem , Sathian Brijesh , Shafiee Sayed Mohammad , Shahabi Saeed , Shahraki-Sanavi Fariba , Shaikh Masood Ali , Sheidaei Ali , Sheikhi Rahim Ali , Shirkoohi Reza , Shobeiri Parnian , Soltani-Zangbar Mohammad Sadegh , Tabibian Elnaz , Taheri Majid , Soodejani Moslem Taheri , Temsah Mohamad-Hani , Tiyuri Amir , Ullah Irfan , Ullah Sana , Tahbaz Sahel Valadan , Valizadeh Rohollah , Vo Bay , Waheed Yasir , Jabbari Seyed Hossein Yahyazadeh , Yazdanpanah Fereshteh , Yuce Deniz , Zaki Nazar , Zare Iman , Zoladl Mohammad , Mokdad Ali H , Naghavi Mohsen , Murray Christopher J L , Larijani Bagher , Farzadfar Farshad TITLE=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 JOURNAL=Frontiers in Oncology VOLUME=13 YEAR=2023 URL=https://www.frontiersin.org/journals/oncology/articles/10.3389/fonc.2023.1132816 DOI=10.3389/fonc.2023.1132816 ISSN=2234-943X ABSTRACT=Background

Breast 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.

Methods

We 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.

Results

In 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.

Conclusion

The 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.