Estimating disparities in breast cancer screening programs towards mortality, case fatality, and DALYs across BRICS-plus
Abstract Background Numerous 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...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-09-01
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| Series: | BMC Medicine |
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| Online Access: | https://doi.org/10.1186/s12916-023-03004-4 |
| _version_ | 1797452355999891456 |
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| author | Sumaira Mubarik Saima Shakil Malik Zhang Yanran Eelko Hak Nawsherwan Fang Wang Chuanhua Yu |
| author_facet | Sumaira Mubarik Saima Shakil Malik Zhang Yanran Eelko Hak Nawsherwan Fang Wang Chuanhua Yu |
| author_sort | Sumaira Mubarik |
| collection | DOAJ |
| description | Abstract Background Numerous 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. Methods In 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. Results Compared 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. Conclusions The 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. |
| first_indexed | 2024-03-09T15:07:40Z |
| format | Article |
| id | doaj.art-3484a500b2f842429395df2009f1839a |
| institution | Directory Open Access Journal |
| issn | 1741-7015 |
| language | English |
| last_indexed | 2024-03-09T15:07:40Z |
| publishDate | 2023-09-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Medicine |
| spelling | doaj.art-3484a500b2f842429395df2009f1839a2023-11-26T13:34:02ZengBMCBMC Medicine1741-70152023-09-0121111410.1186/s12916-023-03004-4Estimating disparities in breast cancer screening programs towards mortality, case fatality, and DALYs across BRICS-plusSumaira Mubarik0Saima Shakil Malik1Zhang Yanran2Eelko Hak3Nawsherwan4Fang Wang5Chuanhua Yu6Department of Epidemiology and Biostatistics, School of Public Health, Wuhan UniversityCenter for Biotechnology & Genomic Medicine (CBGM) Medical College of Georgia Augusta UniversityDepartment of Epidemiology and Biostatistics, School of Public Health, Wuhan UniversityPharmacoTherapy, -Epidemiology and -Economics, Groningen Research Institute of Pharmacy, University of GroningenXiamen Cardiovascular Hospital of Xiamen University, School of Medicine, Xiamen UniversityDepartment of Biostatistics, School of Public Health, Xuzhou Medical UniversityDepartment of Epidemiology and Biostatistics, School of Public Health, Wuhan UniversityAbstract Background Numerous 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. Methods In 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. Results Compared 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. Conclusions The 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.https://doi.org/10.1186/s12916-023-03004-4Breast cancer screeningMortalityCase fatalityDisabilityCVDBRICS-plus |
| spellingShingle | Sumaira Mubarik Saima Shakil Malik Zhang Yanran Eelko Hak Nawsherwan Fang Wang Chuanhua Yu Estimating disparities in breast cancer screening programs towards mortality, case fatality, and DALYs across BRICS-plus BMC Medicine Breast cancer screening Mortality Case fatality Disability CVD BRICS-plus |
| title | Estimating disparities in breast cancer screening programs towards mortality, case fatality, and DALYs across BRICS-plus |
| title_full | Estimating disparities in breast cancer screening programs towards mortality, case fatality, and DALYs across BRICS-plus |
| title_fullStr | Estimating disparities in breast cancer screening programs towards mortality, case fatality, and DALYs across BRICS-plus |
| title_full_unstemmed | Estimating disparities in breast cancer screening programs towards mortality, case fatality, and DALYs across BRICS-plus |
| title_short | Estimating disparities in breast cancer screening programs towards mortality, case fatality, and DALYs across BRICS-plus |
| title_sort | estimating disparities in breast cancer screening programs towards mortality case fatality and dalys across brics plus |
| topic | Breast cancer screening Mortality Case fatality Disability CVD BRICS-plus |
| url | https://doi.org/10.1186/s12916-023-03004-4 |
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