ORIGINAL RESEARCH article
Front. Oncol.
Sec. Breast Cancer
Breast Cancer Burden in the United States (1990–2021) with a 15-Year Forecast: A Comprehensive Analysis Based on the Global Burden of Disease 2021
Provisionally accepted
Zhijian Huang1,2
Lingxiao Zhang3
Peizhang Liu1Hongxiang Lin1Zeyi Peng1Peixin Zheng1Xinhao Sun4*
Lisheng Lin1,5*- 1Fujian Provincial Cancer Hospital, Fuzhou, China
- 2Harvard Medical School, Boston, United States
- 3Massachusetts General Hospital Department of Medicine, Boston, United States
- 4Northeastern University, Boston, United States
- 5Affiliated Hospital of Putian University, Putian, China
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Objective: Breast cancer (BC) is one of the most common cancers globally, placing a significant social burden. This study estimates the BC burden in the U.S. from 1990 to 2021 and projects future trends for the next 15 years. Methods: Using data from the Global Burden of Disease (GBD) 2021 study, we analyzed four measures: prevalence, incidence, death, and disability-adjusted life years (DALYs), stratified by sex, age, U.S. states, and socio-demographic index (SDI). Results: BC burden in the U.S. has decreased, with reductions in age-standardized rates of prevalence, incidence, mortality, and DALYs for both sexes. The overall age-standardized prevalence rate dropped from 695.0 (653.5–741.5)/100,000 in 1990 to 556.0 (525.2– 584.7)/100,000 in 2021. The ASIR declined from 68.3 (65.1–70.3)/100,000 to 51.7 (48.4– 54.1)/100,000. Death rates fell from 15.9 (14.9–16.5)/100,000 to 9.4 (8.5–9.9)/100,000, while DALYs decreased from 485.1 (462.9–507.0)/100,000 to 277.4 (260.1–294.8)/100,000 over the same period. Burden varies by state and SDI: in 2021, low-SDI states, Kentucky and Louisiana had the highest prevalence and incidence, while Louisiana and Mississippi had the highest mortality. Projections suggest a continued downward trend through 2036. Conclusions: BC burden in the U.S. decreased overall, but disparities persist across sex, age groups, and states with varying SDI levels. Addressing risk factors and improving healthcare access are essential to further reduce BC burden.
Keywords: breast cancer, Global burden of disease, Epidemiology, socio-demographic index, U.S.
Received: 20 Jun 2025; Accepted: 24 Oct 2025.
Copyright: © 2025 Huang, Zhang, Liu, Lin, Peng, Zheng, Sun and Lin. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Xinhao Sun, sun.xinh@northeastern.edu
Lisheng Lin, lslin_75@icloud.com
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