Global, regional, and national mortality trends of female breast cancer by risk factor, 1990-2017.
BACKGROUND
Female breast cancer (FBC) is a malignancy involving multiple risk factors and has imposed heavy disease burden on women. We aim to analyze the secular trends of mortality rate of FBC according to its major risk factors.


METHODS
Death data of FBC at the global, regional, and national levels were retrieved from the online database of Global Burden of Disease study 2017. Deaths of FBC attributable to alcohol use, high body-mass index (BMI), high fasting plasma glucose (FPG), low physical activity, and tobacco were collected. Estimated average percentage change (EAPC) was used to quantify the temporal trends of age-standardized mortality rate (ASMR) of FBC in 1990-2017.


RESULTS
Worldwide, the number of deaths from FBC increased from 344.9 thousand in 1990 to 600.7 thousand in 2017. The ASMR of FBC decreased by 0.59% (95% CI, 0.52, 0.66%) per year during the study period. This decrease was largely driven by the reduction in alcohol use- and tobacco-related FBC, of which the ASMR was decreased by 1.73 and 1.77% per year, respectively. In contrast, the ASMR of FBC attributable to high BMI and high FPG was increased by 1.26% (95% CI, 1.22, 1.30%) and 0.26% (95% CI, 0.23, 0.30%) per year between 1990 and 2017, respectively.


CONCLUSIONS
The mortality rate of FBC experienced a reduction over the last three decades, which was partly owing to the effective control for alcohol and tobacco use. However, more potent and tailored prevention strategies for obesity and diabetes are urgently warranted.
['Liu|Hui|H|', 'Shi|Wenjie|W|', 'Jin|Zhi|Z|', 'Zhuo|Rui|R|', 'Dong|Jie|J|', 'Lao|Qiufeng|Q|', 'Li|Shengle|S|', 'Pang|Weiyi|W|']
D000428:Alcohol Drinking D001786:Blood Glucose D015992:Body Mass Index D001943:Breast Neoplasms D002423:Cause of Death D016001:Confidence Intervals D005215:Fasting D005260:Female D014943:Global Health D006801:Humans D009026:Mortality D009765:Obesity D012307:Risk Factors D057185:Sedentary Behavior D012907:Smoking
Mortality Female breast cancer Alcohol Obesity Diabetes Smoking