Comparative examination of breast cancer burden in sub-Saharan Africa, 1990-2019: estimates from Global Burden of Disease 2019 study.

OBJECTIVES: In view of the widening gap in survival data between high-income and low-income countries, this study aimed to evaluate the most up-to-date burden of female breast cancer and analyse the leading risk factors in countries and regions in sub-Saharan Africa.

DESIGN: An analysis of Global Burden of Disease (GBD) data.

SETTING: The data of incidences, deaths, disability-adjusted life years (DALYs) and age-standardised rates (ASR) were retrieved from GBD Results Tool (1 January 1990─31 December 2019) covering 4 sub-Saharan African regions and 44 countries. The burden estimable to the risk factors of breast cancer was also estimated. All estimates were presented as counts and ASR per 100 000 population.

PARTICIPANTS: Participants included patients with female breast cancer.

MAIN OUTCOMES AND MEASURES: Absolute numbers and ASR/estimates of incidence, deaths and DALY of female breast cancer by location in 1990 and 2019, with their percentage changes from 1990 to 2019. The leading risk factors (eg, alcohol consumption) of breast cancer in sub-Saharan Africa.

RESULTS: In sub-Saharan Africa, the incidences of breast cancer increased by 247% in 2019 from 1990, with the highest incidence recorded in Nigeria. The deaths and DALYs of breast cancer increased by 184% and 178%, respectively. From 1990 to 2019, the mortality ASR and DALY ASR increased throughout the region, mostly in Equatorial and Gabon. With varying trends between countries, alcohol consumption and high fasting plasma glucose were noted to be significant contributors to breast cancer deaths between 1990 and 2019.

CONCLUSION: The results show the increasing burden of breast cancer in sub-Saharan Africa and provide valuable information on the trends of breast cancer and the risk factors attributable to breast cancer across sociodemographic index, region and country. These findings may inform health policies and improve the rational allocation of health resources.