Burden and Projections of Premenopausal and Postmenopausal Breast Cancer Worldwide: A Comprehensive Analysis of GLOBOCAN 2022 Data.

Abstract

Breast cancer is the most diagnosed cancer among women worldwide, yet important epidemiological differences exist between premenopausal and postmenopausal disease. Updated global estimates stratified by menopausal status are limited. This study aimed to quantify the global, regional, and national burden of premenopausal and postmenopausal breast cancer in 2022 and to project future trends through 2050. Breast cancer incidence and mortality data for 2022 were obtained from the International Agency for Research on Cancer GLOBOCAN database. Women aged 15-49 years were classified as premenopausal and those aged ≥ 50 years as postmenopausal. Age-standardized incidence rates (ASIRs), age-standardized mortality rates (ASMRs), cumulative risk, and mortality-to-incidence ratios (MIRs) were estimated for 185 countries. Countries were further stratified by the Human Development Index (HDI) published by the United Nations Development Programme. Temporal trends were assessed using estimated annual percentage change (EAPC), and projections to 2050 were derived using the World Health Organization Cancer Tomorrow tool. In 2022, an estimated 2,296,607 new breast cancer cases and 666,061 deaths occurred globally. Premenopausal women accounted for 668,417 cases (29.1%) and 141,338 deaths (21.2%), while postmenopausal women accounted for 1,628,190 cases (70.9%) and 524,723 deaths (78.8%). Global ASIRs were 32.7 and 153.9 per 100,000 for premenopausal and postmenopausal women, respectively. Incidence rates were highest in very high-HDI countries, whereas mortality and MIR were markedly higher in low-HDI countries. Africa showed the highest MIRs for both premenopausal (40.3%) and postmenopausal (51.8%) breast cancer. HDI was positively correlated with cumulative incidence risk but strongly inversely correlated with MIR. By 2050, global cases are projected to increase to 795,908 for premenopausal and 2,756,889 for postmenopausal breast cancer. Substantial global disparities exist in breast cancer burden and outcomes. While high-income countries experience higher incidence, low-resource settings bear disproportionately higher mortality. Strengthening early detection, treatment access, and cancer control systems is essential to reduce global inequities and address the growing burden of breast cancer.