Global, regional, and national burden of male breast cancer and predictions in the next 30 years: a systematic analysis of the global burden of disease study 2021

Abstract

Background: Breast cancer, the most common cancer in women, also affects men. However, detailed assessments of the disease burden and future projections for male breast cancer (MBC) remain limited.

Methods: Data on global male breast cancer mortality, disability-adjusted life years (DALYs), prevalence, and incidence from 1990 to 2021 were analyzed. We used the Estimated Annual Percentage Change (EAPC) to assess MBC trends and analyzed regional and age impacts on disease burden. The Slope Inequality Index (SII), Concentration Index (C-I), and Frontier analysis delineated inequalities and future trends. The Age-Period-Cohort (APC) model clarified population dynamics. We also identified risk factors and applied the ARIMA model to forecast disease burden changes over the next 30 years.

Results: Between 1990 and 2021, MBC deaths and DALYs showed a global increase. The EAPC for deaths was 0.66 (0.56-0.76), with the middle Socio-Demographic Index (SDI) region experiencing the most significant rise at 2.0 (1.76-2.24). DALYs had an EAPC of 0.85 (0.75-0.95), and the Middle SDI region saw the most notable increase with an EAPC of 2.16 (1.89-2.42). The global prevalence and incidence also increased, with EAPCs of 2.3 (2.13-2.46) and 2.21 (2.05-2.37) respectively. Disease burden was high and decreasing in low SDI regions, but low and stable in high SDI regions. The Age-standardized rate(ASR)-Deaths correlated negatively with SDI. ASR-Prevalence showed a negative correlation with SDI when SDI was below 0.5, a positive correlation when SDI was between 0.5 and 0.8, and a negative correlation again when SDI exceeded 0.8. Disease burden increased with age initially, peaking in the 65-69 age group for deaths, prevalence, and incidence, then decreasing. DALYs peaked in the 60-64 age group. High red meat consumption was associated with increased mortality risk. Projections suggest that while the total MBC burden will rise over the next 30 years, ASR-Deaths and DALYs will decline globally, and prevalence and incidence will increase.

Conclusion: Global male breast cancer deaths and DALYs are rising. Low SDI regions bear a higher disease burden, which is decreasing over time, while high SDI regions maintain a lower, stable burden. Over the next 30 years, the total disease burden is projected to increase further. Given these trends, male breast cancer remains a significant global health concern, and emerging disease patterns must inform new control policies.

Keywords: ASR; DALYs; EAPC; Epidemiology; Global burden; Male breast cancer.

Fig. 1

The map of global burden of MBCacross 204 countries or territories (1990–2021). A deaths, B DALYs, C prevalence, D incidence

Fig. 2

Results of cluster analysis based on the number of deaths and the EAPC in the number of deaths from 1990 to 2021

Fig. 3

Cross-Country Inequalities of MBC, 1990–2021. A ASR of MBC; B DALYs; C Prevalence; D Incidence; (1) Health inequality regression curves for MBC. (2) Concentration curves, (3) SII curves

Fig. 4

Frontier analysis involving SDI and burden of MBC in 2021. From left to right: A, a ASR-Deaths of MBC; B, b DALYs; C, c prevalence and D, d incidence. The leading edge is marked with a solid black line and countries and regions are indicated by dots. Red dots represent the decrease in the burden of MBC between 1990 to 2021. Blue dots represent an increase in the burden of MBC over the same time period

Fig. 5

Age trends in MBC disease burden, 1990–2021. A Deaths, B DALYs, C Prevalence, D Incidence

Fig. 6

Results of the age-period-cohort analysis. A Deaths, B DALYs, C prevalence, D incidence

Fig. 7

Relationship between MBC burden and SDI. A and B: ASR-Deaths vs. SDI, C and D: ASR prevalence vs. SDI.