Breast Cancer Prevalence in China and Malaysia (1992-2021): Trends, Determinants, and Projections to 2050.
TL;DR
The analysis confirms that breast cancer prevalence will increase substantially in both countries by 2050, with Malaysia facing a particularly heavy burden, and supports the hypothesis that socioeconomic development drives prevalence through lifestyle and reproductive transitions.
Abstract
Background
Breast cancer represents a growing public health challenge in Asia, with heterogeneous trends across countries. We aimed to characterise temporal trends in breast cancer prevalence in China and Malaysia and project future burden to inform health policy planning.
Methods
We conducted a comparative ecological time-series analysis using breast cancer prevalence data from the Global Burden of Disease Study 2021 for China and Malaysia (1992-2021). Using R version 4.3.0, we examined sex-specific and age-stratified trends, incorporating socioeconomic (GDP per capita) and environmental (PM2.5) covariates. Our study population comprised nationwide estimates, with no sampling required. Using multivariate regression models, we projected prevalence to 2050 with 95% confidence intervals. We conducted sensitivity analyses removing outliers and testing model assumptions.
Results
From 1992 to 2021, breast cancer prevalence increased substantially in both countries, with marked sex differences. In China, female prevalence rose from 334.3 per 100,000 (1992) to 650.5 per 100,000 (2021), while male prevalence remained low (25.2 per 100,000 in 2021). Malaysia showed higher absolute prevalence, with female rates increasing from 487.5 per 100,000 (1992) to 928.7 per 100,000 (2021). By 2050, we project female breast cancer prevalence will reach 747.6 per 100,000 (95% CI 468.8-1026.3) in China and 1388.1 per 100,000 (95% CI 941.6-1834.6) in Malaysia. GDP per capita showed positive associations with prevalence (p<0.001), while PM2.5 exposure demonstrated negative correlations. Age-stratified analysis revealed peak prevalence in the 50-69 years age groups.
Conclusion
Our analysis confirms that breast cancer prevalence will increase substantially in both countries by 2050, with Malaysia facing a particularly heavy burden (1388.1 per 100,000 females, 49.5% increase from 2021). The significant positive association with GDP per capita (p<0.001) supports our hypothesis that socioeconomic development drives prevalence through lifestyle and reproductive transitions. These findings underscore the urgent need for strengthened prevention strategies, early detection programmes, and healthcare system capacity building in both countries, with particular emphasis on Malaysia's healthcare infrastructure development.