Estimating disparities in breast cancer screening programs towards mortality, case fatality, and DALYs across BRICS-plus

BMC Medicine

Research Article

Saima Shakil Malik¹  Fang Wang²  Chuanhua Yu³  Sumaira Mubarik⁴  Zhang Yanran⁵  Eelko Hak⁶ 

[1] Center for Biotechnology & Genomic Medicine (CBGM) Medical College of Georgia Augusta University, 1462 Laney Walker Blvd, 30912-4810, Augusta, GA, USA;Department of Biostatistics, School of Public Health, Xuzhou Medical University, 221004, Xuzhou, Jiangsu, China;Department of Epidemiology and Biostatistics, School of Public Health, Wuhan University, 185 Donghu Road, 430071, Wuhan, Hubei, China;Department of Epidemiology and Biostatistics, School of Public Health, Wuhan University, 185 Donghu Road, 430071, Wuhan, Hubei, China;PharmacoTherapy, -Epidemiology and -Economics, Groningen Research Institute of Pharmacy, University of Groningen, Groningen, The Netherlands;Department of Epidemiology and Biostatistics, School of Public Health, Wuhan University, 185 Donghu Road, 430071, Wuhan, Hubei, China;Wuhan Jinyintan Hospital, Tongji Medical College of Huazhong University of Science and Technology; Hubei Clinical Research Center for Infectious Diseases; Wuhan Research Center for Communicable Disease Diagnosis and Treatment, Chinese Academy of Medical Sciences; Joint Laboratory of Infectious Diseases and Health, Wuhan Institute of Virology and Wuhan Jinyintan Hospital, Chinese Academy of Sciences, Wuhan, Hubei, China;PharmacoTherapy, -Epidemiology and -Economics, Groningen Research Institute of Pharmacy, University of Groningen, Groningen, The Netherlands;

关键词: Breast cancer screening;    Mortality;    Case fatality;    Disability;    CVD;    BRICS-plus;   

DOI  :  10.1186/s12916-023-03004-4

 received in 2023-04-13, accepted in 2023-07-25,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundNumerous studies over the past four decades have revealed that breast cancer screening (BCS) significantly reduces breast cancer (BC) mortality. However, in BRICS-plus countries, the association between BCS and BC case fatality and disability are unknown. This study examines the association of different BCS approaches with age-standardized mortality, case-fatality, and disability-adjusted life years (DALYs) rates, as well as with other biological and sociodemographic risk variables, across BRICS-plus from a national and economic perspective.MethodsIn this ecological study applying mixed-effect multilevel regression models, a country-specific dataset was analyzed by combining data from the Global Burden of Disease study 2019 on female age-standardized BC mortality, incidence, and DALYs rates with information on national/regional BCS availability (against no such program or only a pilot program) and BCS type (only self-breast examination (SBE) and/or clinical breast examination (CBE) [SBE/CBE] versus SBE/CBE with mammographic screening availability [MM and/or SBE/CBE] versus SBE/CBE/mammographic with digital mammography and/or ultrasound (US) [DMM/US and/or previous tests] in BRICS-plus countries.ResultsCompared to self/clinical breast examinations (SBE/CBE) across BRICS-plus, more complex BCS program availability was the most significant predictor of decreased mortality [MM and/or SBE/CBE: − 2.64, p < 0.001; DMM/US and/or previous tests: − 1.40, p < 0.001]. In the BRICS-plus, CVD presence, high BMI, second-hand smoke, and active smoking all contributed to an increase in BC mortality and DALY rate. High-income and middle-income regions in BRICS-plus had significantly lower age-standardized BC mortality, case-fatality, and DALYs rates than low-income regions when nationwide BC screening programs were implemented.ConclusionsThe availability of mammography (digital or traditional) and BCS is associated with breast cancer burden in BRICS-plus countries, with regional variations. In light of high-quality evidence from previous causal studies, these findings further support the preventive role of mammography screening for BCS at the national level. Intervening on BCS related risk factors may further reduce the disease burden associated with BC.

【 授权许可】

CC BY   
© BioMed Central Ltd., part of Springer Nature 2023

【 图 表 】

13690_2023_1170_Article_IEq138.gif

Fig. 3

Fig. 3

Fig. 2