Burden of breast cancer in 29 EEA countries: trends, disparities and public health implications

Background

Breast cancer remains the most commonly diagnosed cancer and a leading cause of cancer-related mortality among women in Europe, with notable variation across countries. Despite advances in detection and treatment, modifiable risk factors continue to influence disease burden. This study aims to assess the burden of breast cancer across EEA countries, examining temporal trends and geographic disparities to inform prevention and policy strategies.

Methods

We retrieved rates for disability-adjusted life years (DALYs), incidence, and deaths from the GBD 2023 study for 29 EEA countries (EU-27, Iceland, and Norway; data for Liechtenstein was not available) for females aged 40 to 85+ years, which we then weighted using the European Standard Population 2013 to obtain age-standardized rates (reported per 100,000). In addition, we calculated the estimated annual percentage change (EAPC) with 95% CI for 1990-2023. We conducted all analyses using R4.3.3.

Results

In 2023, the age-adjusted DALY rates for breast cancer ranged between 1,139.7 in Norway and 1,869.0 in Germany while the age-adjusted incidence rate was between 150.2 in Bulgaria and 330.9 in France. Age-adjusted mortality rates ranged between 48.0 in Norway and 84.5 in Denmark. Between 1990 and 2023, the EAPC ranged between -2.75% (95% CI: -2.94% and -2.55%; Denmark) and 0.17% (95% CI: 0.02% and 0.32%; Romania) for DALY rates, -0.88% (95% CI: -1.07% and -0.69%; Denmark) and 2.07% (1.81% and 2.32%; Cyprus) for incidence rates, and -2.21% (95% CI: -2.44% and -1.98%; Denmark) and 0.60% (95% CI: 0.44% and 0.76%; Romania) for mortality rates.

Conclusions

Our findings indicate that the disease burden has not suffered major decreases (reflected in both increases and decreases in the EAPC) highlighting the need for stronger efforts in breast cancer awareness and screening, alongside targeted policies addressing modifiable risk factors such as obesity, physical inactivity, and alcohol consumption.

Key messages

• The burden of breast cancer across EEA countries has not suffered major decreases, although variation exist between countries and burden of disease metrics.

• Targeted action on screening, awareness, and modifiable risk factors is needed to reduce disparities and improve outcomes across the EEA.