Women’s breast cancer mortality trends: The impact of lifestyle factors from the 2021 Global Burden of Disease (GBD) study.

Abstract

10602 Background: Breast cancer (BC) remains a leading cause of death among women globally. Understanding the role of modifiable risk factors is critical for designing targeted prevention strategies. The 2021 GBD study offers a comprehensive analysis of global health, quantifying the impact of diseases and risk factors on morbidity and mortality worldwide. This study provides an updated risk factor analysis in relation to women’s BC mortality over the past three decades. Methods: Data from the study were used to examine trends in BC mortality in the United States from 1990 to 2021, stratified by age group representing younger pre-menopausal (ages 20-54) and older post-menopausal women (ages ≥55), associated with five key risk factors: tobacco use, red meat consumption, alcohol consumption, high body mass index (BMI), and high fasting plasma glucose (FPG). Age-standardized mortality rates (ASMR) were calculated for each factor, and differences between age groups were analyzed. All rates were reported per 100,000 population. Joinpoint regression analysis was conducted to evaluate trends. Results: In 2021, a high red meat diet (consuming >70 g/day of red meat), was the leading risk factor for BC-ASMR overall (2.3), both in older (11.4) and younger (1.4) women, contributing 14% to ASMR across all age groups. Older women had significantly higher ASMR for all risk factors (Table 1). From 1990 to 2021, tobacco-associated BC-ASMR exhibited the greatest decline, with a global reduction of 55.06%, more pronounced in younger (58.39%) than older (46.58%) women. Alcohol-related mortality also decreased significantly, more evident in younger (37.69%) than older (13.09%) women. While the absolute increase in risk factor-associated ASMR was observed with high FPG (+4.4%), a proportional ASMR increase was observed for all three metabolism-related risk factors, including high FPG (+75%), high BMI (+32%), and alcohol use (+14%). High FPG was associated with increased BC-ASMR in both age groups, while younger women experienced a significant rise due to high BMI (+689%). Conclusions: These findings highlight the impact of modifiable risk factors on BC mortality. There is a notable reduction in tobacco and alcohol-related deaths, particularly among younger women, likely due to public health campaigns and smoking cessation programs. Moreover, the rising prevalence of alcohol intake in older women, the growing impact of metabolic-related morbidity in younger women, and the hormonal changes amplifying BMI-related risks in post-menopausal women, stress the need for targeted health interventions that could markedly reduce the burden of BC mortality globally. Risk factors Overall trend(1990-2021) Ages 20-54 Ages ≥55 Tobacco 1.4→0.6 1.1→0.5 5.2→2.8 Alcohol use 1.4→1 1.3→0.8 4.6→4 High FPG 1.1→1.1 0.36→0.39 5.7→6.2 High BMI 2→1.6 0.02→0.1 12.5→10.4 Diet high in red meat 3.9→2.3 2.3→1.4 17.4→1.5