A Hierarchical Age–Period–Cohort Analysis of Breast Cancer Mortality and Disability Adjusted Life Years (1990–2015) Attributable to Modified Risk Factors among Chinese Women

Sumaira Mubarik, Fang Wang, Saima Shakil Malik, Fang Shi, Yafeng Wang, Nawsherwan and Chuanhua Yu
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Sumaira Mubarik: Department of Epidemiology and Biostatistics, School of Health Sciences, Wuhan University, Wuhan 430071, China
Fang Wang: Department of Epidemiology and Biostatistics, School of Health Sciences, Wuhan University, Wuhan 430071, China
Saima Shakil Malik: Department of Zoology, University of Gujrat, Gujrat 50700, Pakistan
Fang Shi: Department of Epidemiology and Biostatistics, School of Health Sciences, Wuhan University, Wuhan 430071, China
Yafeng Wang: Department of Epidemiology and Biostatistics, School of Health Sciences, Wuhan University, Wuhan 430071, China
Nawsherwan: Department of Nutrition and Food Hygiene, School of Health Sciences, Wuhan University, Wuhan 430071, China
Chuanhua Yu: Department of Epidemiology and Biostatistics, School of Health Sciences, Wuhan University, Wuhan 430071, China

IJERPH, 2020, vol. 17, issue 4, 1-13

Abstract: Limited studies quantified the age, period, and cohort effects attributable to different risk factors on mortality rates (MRs) and disability-adjusted life years (DALYs) due to breast cancer among Chinese women. We used data from the Global Burden of Disease Study (GBD) in 2017. Mixed-effect and hierarchical age–period–cohort (HAPC) models were used to assess explicit and implicit fluctuations in MRs and DALYs attributable to different breast cancer associated risk factors. As the only risk factor, high body mass index (HBMI) showed continuously increasing trends in MRs and DALYs across ages, periods, and cohorts. Age, recent periods (2010–2015), and risk factor HBMI showed significant positive effect on MRs and DALYs ( p < 0.05). Moreover, we reported significant interaction effects of older age and period in recent years in addition to the interplay of older age and risk factor HBMI on MRs and DALYs. Increased age and obesity contribute to substantially raised breast cancer MRs and DALYs in China and around the globe. These discoveries shed light on protective health policies and provision of healthy lifestyle for improving the subsequent breast cancer morbidity and mortality for China, as well as other related Asian regions that are presently facing the same public health challenges.

Keywords: mortality rates; age; cohort; breast cancer; high body mass index; China (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2020
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