The burden of breast cancer among women aged ≥70 years: Global trends in DALYs and mortality by socio-demographic index, 1990–2023.

Abstract

e12700 Background: Breast cancer remains a major public health concern with high morbidity and mortality worldwide, particularly among women aged ≥70 years. Despite advances in diagnosis, treatment, and prevention, substantial disparities in DALYs and mortality persist across socio-demographic index (SDI) regions. Methods: Data from GBD 2023 were used to assess Disability Adjusted Life Years (DALYs) and mortality rates per 100,000 population in women aged ≥70 years. Analyses were stratified by SDI groups (low, low-middle, middle, high-middle). Joinpoint regression estimated trends, and AAPC with 95% CI was calculated; p < 0.05 indicated significance. Results: From 1990 to 2023, the consistently higher rates in DALYs were observed in the middle SDI group, with rates rising from 120.79 in 1990 to 299.32 in 2023 (AAPC: 2.83; 95% CI: 2.74 to 2.91; p < 0.000001). This was followed by the low-middle SDI group, which showed a continuous increase in DALYs from 117.09 in 1999 to 297.63 in 2023 (AAPC: 2.87; 95% CI: 2.66 to 3.09; p < 0.000001). The low SDI group demonstrated comparatively lower rates; however, DALYs still rose markedly from 114.47 in 1999 to 262.25 in 2023 (AAPC: 2.52; 95% CI: 2.32 to 2.72; p < 0.000001). The high-middle SDI group also experienced a modest but comparatively lower increase, with DALYs rising from 143.67 in 1990 to 230.74 in 2023 (AAPC: 1.46; 95% CI: 1.30 to 1.62; p < 0.000001). A similar pattern was noted in mortality trends. From 1980 to 2023, the middle SDI group exhibited the highest mortality rates, increasing from 5.02 in 1980 to 14.88 in 2023 (AAPC: 2.59; 95% CI: 2.52 to 2.66; p < 0.000001). The low-middle SDI group followed, with mortality rising from 4.82 in 1980 to 14.26 in 2023 (AAPC: 2.58; 95% CI: 2.28 to 2.87; p < 0.000001). The low SDI group recorded lower but steadily increasing rates, from 4.84 in 1980 to 11.73 in 2023 (AAPC: 2.08; 95% CI: 1.90 to 2.26; p < 0.000001). The high-middle SDI group showed the smallest relative rise, with mortality increasing from 6.46 in 1980 to 11.69 in 2023 (AAPC: 1.38; 95% CI: 1.23 to 1.53; p < 0.000001). Conclusions: Breast cancer in women aged ≥70 years remains a significant global health burden, with the highest impact in middle and low-middle SDI regions. Strengthening geriatric-focused screening, timely diagnosis, and equitable treatment strategies is critical to reduce disease burden in this population. Average annual percentage changes (AAPC) for mortality rates and disability adjusted life years (DALYs) rates for each region. Mortality Rates per 100,000 Disability Adjusted Life Years (DALYs) per 100,000 Region AAPC Region AAPC Low SDI 2.0817* Low SDI 2.5255* Low-middle SDI 2.5810* Low-middle SDI 2.8792* Middle SDI 2.5916* Middle SDI 2.8313* High-middle SDI 1.3828* High-middle SDI 1.4662* *Shows that the trend was statistically significant at alpha = 0.05.