Rising Global Burden of Alcohol-Attributable Breast Cancer in Women: Regional Inequalities and Temporal Trends

Breast cancer is the most common malignancy and a leading cause of death among women of reproductive age. Although high alcohol consumption is a known modifiable risk factor, its global and regional impact on breast cancer mortality and disability-adjusted life years (DALYs) remains insufficiently characterized.

Data on alcohol-attributable breast cancer mortality and DALYs among women aged 15-49 years were extracted across 204 countries and territories from 1990 to 2021. Temporal trends were assessed using estimated annual percentage changes (EAPC). Correlations with the sociodemographic index (SDI) were examined, and projections to 2050 were modeled to estimate future patterns.

Globally, alcohol-attributable breast cancer mortality declined from 0.27 to 0.17 per 100,000 (EAPC -1.79%), and DALYs from 14.00 to 9.02 per 100,000 (EAPC -1.71%). Women aged 45-49 had the highest mortality, though rates fell significantly (EAPC -2.71%). High-SDI regions, especially Western Europe, North America, and Australasia, saw marked reductions. In contrast, low- and middle-SDI regions experienced sharp increases, with mortality rising over 300% in low-middle SDI areas and South Asia (EAPC +2.57% and +2.87%, respectively). The United States, Brazil, and China recorded the highest national rates, while Gulf States had the lowest. Mortality and DALY rates correlated positively with SDI (ρ = 0.709 and 0.719). Projections suggest continued declines in high-SDI areas but worsening trends in low-SDI settings by 2050.

Despite global progress, rising alcohol-attributable breast cancer burdens in less developed regions underscore the need for targeted prevention and alcohol control efforts.