Age-standardized breast cancer mortality among adult women in China experienced a gradual downward trend between 2004 and 2021, according to an analysis of national surveillance data. While age-adjusted mortality decreased over the seventeen-year observation period, crude mortality rates increased, and substantial disparities across age groups, geographic regions, and urban-rural settings persisted.
The investigation utilized death records from China’s national Disease Surveillance Points system, focusing on breast cancer mortality among women aged 20 years and older. In total, the surveillance network monitored a cumulative population of 1,163,902,200 person-years among women and documented 108,048 reported breast cancer deaths between 2004 and 2021.
Over the course of the study window, the crude mortality rate rose from 7.9 deaths per 100,000 women in 2004 to 10.2 per 100,000 in 2021. Conversely, the age-standardized mortality rate declined from 6.5 per 100,000 to 5.9 per 100,000. Joinpoint regression analysis revealed an annual percent change of -0.41 (95% confidence interval: -1.11 to 0.33, P = 0.246), indicating that the observed decrease in age-standardized mortality was not statistically significant, with no significant joinpoints identified across the timeline.
Demographic and geographic comparisons demonstrated persistent differences across sub-populations throughout the seventeen years analyzed. Breast cancer mortality rates in urban areas remained consistently higher than those recorded in rural areas. Regional evaluations showed that breast cancer mortality was higher in eastern and central China compared to the western region of the country.
To evaluate independent demographic influences, researchers constructed an age-period-cohort model estimating relative risks and 95% confidence intervals across age groups, calendar periods, and birth cohorts. The analysis indicated that age exerted the strongest effect on mortality risk, with the relative risk rising steadily as age advanced. Time-period effects remained relatively stable across the surveillance years, whereas birth cohort effects demonstrated an overall declining trend.
The study also incorporated a sensitivity analysis stratifying data into pre-expansion (2004–2012) and post-expansion (2013–2021) intervals to evaluate whether structural expansions of the Disease Surveillance Points system influenced the mortality patterns. Based on the enduring differences observed across age categories, urban-rural residence, and geographic regions, the authors conclude that sustained monitoring and targeted prevention efforts directed at high-risk populations and high-burden areas remain necessary to address mortality and health inequities.
Subject of Research: Long-term trends and population disparities in breast cancer mortality among adult women in China
Article Title: Temporal trends and population disparities in breast cancer mortality in China (2004–2021): a joinpoint regression analysis of national surveillance data
Article References: Yuting, Y., Xi, N., Liu, B., Chen, A., & Huang, C. (2026). Temporal trends and population disparities in breast cancer mortality in China (2004–2021): a joinpoint regression analysis of national surveillance data. BMC Cancer. https://doi.org/10.1186/s12885-026-17259-6
Image Credits: AI Generated
DOI: 10.1186/s12885-026-17259-6
Keywords: Breast cancer mortality, Disease Surveillance Points system, Age-standardized mortality rate, Joinpoint regression, Annual percent change, Age-period-cohort model, Urban-rural disparities, Regional disparities, Crude mortality rate, Birth cohort effects, Period effects, Relative risk, Pre-expansion period, Post-expansion period, Surveillance population, Person-years analysis, Female cancer epidemiology
