Trends in breast cancer incidence, mortality, and disability-adjusted life years in Europe, 1990-2023: A region- and sex-specific analysis.

Abstract

e12721 Background: Breast cancer is a major contributor to the cancer burden in Europe, with marked regional and sex-specific variation in incidence, mortality, and disability-adjusted life years (DALYs). This study examines region and sex-specific trends in breast cancer incidence, mortality, and DALYs in Europe from 1990 to 2023. Methods: Breast cancer incidence, mortality, and DALYs were analyzed using Global Burden of Disease estimates from 1990-2023. Data were stratified by sex and European subregions. Data was analyzed using multiple joint point models via linear regression analysis. Age-standardized rates were assessed using log-linear regression to estimate annual percent change (APC) and average annual percent change (AAPC) for the full period, with 95% confidence intervals (CIs). Results: From 1990 to 2023, breast cancer incidence increased across Europe. Incidence rose most in Central Europe (AAPC: +1.78% 95% CI: +1.40 to +2.17) and Western Europe (AAPC: +1.59% 95% CI: +1.05 to +2.13), driven by rapid increases during 1990-2000 Central Europe (APC: +2.22% 95% CI: +1.89 to +2.55); Western Europe (APC: +1.54% 95% CI: +1.12 to +1.96) and slower growth and stabilization during 2001-2023. Eastern Europe showed an early rise 1990-2000 APC: +3.76% 95% CI: +3.21 to +4.31 followed by sustained declines in 2001-2023 (APC: -0.94%, 95% CI: -1.19 to -0.69), yielding an overall decrease (AAPC: -0.84% 95% CI: -1.14 to -0.54). Incidence increases were greater among females, while male incidence rose in Central and Western Europe. In contrast, mortality and DALY rates declined across all subregions, with the largest reductions in Western Europe Mortality (AAPC: -1.63%, 95% CI: -1.71 to -1.56); DALYs (AAPC: -1.74%, 95% CI: -1.81 to -1.66), followed by Eastern Europe Mortality (AAPC: -0.55%, 95% CI: -0.82 to -0.28); DALYs (AAPC: -0.88%, 95% CI: -1.15 to -0.61) and Central Europe Mortality (AAPC: -0.39%, 95% CI: -0.49 to -0.29); DALYs (AAPC: -0.70%, 95% CI: -0.79 to -0.60). Trends were non-linear, with the largest increases in Eastern Europe during 1990-2000 Mortality (APC: +1.65%, 95% CI: +1.05 to +2.25); DALYs (APC: +4.60%, 95% CI: +4.07 to +5.14), alongside smaller increases in Central Europe and stable or declining trends in Western Europe, followed by the steepest declines in Eastern Europe during 2001-2023 Mortality (APC: -1.50%, 95% CI: -1.69 to -1.31); DALYs (APC: -2.45%, 95% CI: -2.59 to -2.32), with more modest declines in Central and Western Europe. Females experienced greater mortality and DALY reductions, whereas male trends were less favorable in some regions. Conclusions: From 1990 to 2023, breast cancer incidence increased across much of Europe, particularly in Central and Western regions and among females, while mortality and DALYs declined. Reductions were greatest in Western Europe, with persistent regional and sex-specific differences in long-term trends.