| 要約: | Objective To analyze the breast cancer disease burden in Sinosphere countries from 1990 to 2021, and to provide evidence for the development of breast cancer prevention and control policies.Methods Using data from the Global Burden of Disease Study 2021, the incidence, mortality, disability-adjusted life years (DALYs), and average annual percent change (AAPC) were analyzed to assess the breast cancer burden in six Sinosphere countries (China, Japan, South Korea, Singapore, Vietnam, and North Korea) and globally. Joinpoint regression was used to evaluate temporal trends, age–period–cohort (APC) models to assess the independent effects of age, period, and birth cohort, and Bayesian APC models to project the burden from 2022 to 2036.Results In 2021, China reported the highest absolute numbers of new cases (402,800), deaths (91,500), and DALYs (3,029,400 person-years) among Sinosphere countries. Japan had the highest age-standardized incidence rate (ASIR, 31.93 per 100,000), Vietnam the highest age-standardized mortality rate (ASMR, 6.23 per 100,000), and North Korea the highest age-standardized DALY rate (ASDR, 201.05 per 100,000 person-years). From 1990 to 2021, ASIR increased in all Sinosphere countries, with the greatest increase observed in South Korea [AAPC=3.47%, 95%CI (3.26%, 3.68%)]. Japan showed the largest increases in ASMR [AAPC=1.00%, 95%CI (0.78%, 1.21%)] and ASDR [AAPC=0.75%, 95%CI (0.55%, 0.95%)]. The results of the APC model showed that the age effects of breast cancer incidence, mortality, and DALY rates in Sinosphere countries are all on the rise. The risk of developing breast cancer continued to increase among younger cohorts, while mortality and DALY risks in younger generations remained stable or declined in most countries. In contrast, Vietnam showed increasing mortality and DALY risks in younger cohorts. From 2022 to 2036, it is predicted that the breast cancer ASIR will continue to rise in China, Vietnam, and North Korea, while only China will show an increasing trend in breast cancer ASMR and ASDR.Conclusion Breast cancer burden varies across the Sinosphere countries, with China carrying the highest absolute burden and showing the most pronounced upward trend over the next 15 years. Strengthened preventive strategies, enhanced public awareness, effective screening programs, and accelerated advances in medical technology are urgently needed to reduce disability and mortality rates in China. Lessons learned from successful experiences in other Sinosphere countries should be actively applied to mitigate the rising breast cancer burden.
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