Incidence and mortality of breast cancer among adolescent and young adult women worldwide in 2022 and projections for 2040: Implications for surgery.
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BACKGROUND: Breast cancer remains a major public health concern worldwide and is the most common malignancy among women. Although it predominantly affects women over 50 years, a growing number of cases occur in adolescents and young adults (AYA; aged 15-39 years). In low- and middle-Human Development Index (HDI) countries, particularly in sub-Saharan Africa, this group faces disproportionately high mortality rates. METHODS: Number of new cases, deaths, and age-standardized rates (ASR) per 100,000 women aged 15-39 years in 2022 were extracted from the Global Cancer Observatory (GLOBOCAN) database. Data were analyzed for 185 countries and aggregated by the six United Nations regions. Projections to 2040 were estimated by applying 2022 age-specific rates to UN national population forecasts, assuming stable cancer risk and mortality patterns over time. RESULTS: In 2022, an estimated 245,827 new cases of breast cancer occurred among AYA women, representing 10.7% of all breast cancer cases. Asia accounted for the largest number of incident cases (49% of the global total), while Africa showed the highest mortality rates (6.2 per 100,000 AYA). At the national level, the proportion of AYA cases ranged from 43.6% in The Gambia to 3.3% in Finland. By 2040, the number of breast cancer cases among AYA women is projected to increase by 7.6% globally, with Africa showing an approximately 57% increase in the numbers of incident cases and deaths. CONCLUSION: The rising burden of breast cancer among AYA women highlights a critical need to strengthen health systems in low- and middle-HDI countries. Our findings may help inform health system planning in regions where the burden of breast cancer among AYA women is projected to increase. They support consideration of context-appropriate strategies to improve early diagnosis, expand access to multidisciplinary cancer care, and strengthen surgical capacity, including oncoplastic and reconstructive surgery, where appropriate.