Comparative analysis of breast cancer burden in China, India, and the United States

Breast cancer burden varies dramatically across countries at different stages of economic and epidemiological transition. This study assessed the burden, trends, and risk factors of female breast cancer in China, India, and the United States (1990-2023) using GBD 2023 data. Significant epidemiological heterogeneity was observed. India experienced the fastest rising burden, with its age-standardized incidence rate more than doubling. China showed a distinct pattern of rising incidence but declining mortality, while the United States demonstrated consistent declines across all burden indicators. Decomposition analysis revealed the increase in China was primarily driven by demographic factors, whereas India faced both demographic and adverse epidemiological changes. The United States achieved reductions through epidemiological improvements offsetting demographic pressures. Leading risk factors were high red meat intake (China), high fasting plasma glucose (India), and high body-mass index (the United States) Projections to 2050 indicate diverging trajectories, underscoring the need for tailored, country-specific prevention strategies.