National Burden of Breast Cancer in Saudi Arabia, 1990–2023, With Forecasts to 2050: A Systematic Analysis for the Global Burden of Disease Study 2023
Authors: Yazan J. Alalwani, Shimah Maibed Alsalhi, Nawaf Salem Baradhwan, Rahaf Muqbil Alsubaie, Norah Abdullah Alhweish, Rawan Abdullah A. Jarah, Lujain Abdulrahman Alsarhan, Reem Mohammed A. Albarrak, Zahra Shafiq Yousef Almatar, Njood Mohammed Faleh Alhajri, Rahaf Abdullah Ali Alshahrani, Eiman Mohammed AlShammari, Ahmed Y. Azzam
DOI: 10.65416/ehealthsci.2026.117757
Abstract
Introduction: Breast cancer represents the most common malignancy among Saudi Arabian women; however, structured population-level burden assessments integrating advanced epidemiological methods remain limited. We quantified the growing burden of breast cancer in Saudi Arabia from 1990 to 2023 and projected trends to 2050. Methods: Using Global Burden of Disease 2023 estimates, we analyzed incidence, mortality, and disability-adjusted life-years (DALYs) through joinpoint regression, age-period-cohort modeling, and Das Gupta decomposition. Forecasts utilized Bayesian model averaging across four statistical models. Healthcare system performance was assessed via mortality-to-incidence ratio trajectories against socio-demographic index benchmarks. Results: Incident cases increased from 454 (95% Uncertainty Interval [UI]: 322–630) in 1990 to 4,168 (3,009–5,990) in 2023, representing an 818% increase. Age-standardized incidence rose from 6.47 to 19.58 per 100,000 (+203%). Deaths increased from 243 to 1,197 (+393%), while DALYs rose from 8,524 to 43,561 (+410%). The mortality-to-incidence ratio improved from 0.535 to 0.362 (−32%), indicating enhanced survival. Age effects explained 77.7% of variance in incidence patterns, with period effects contributing 20.6%. Decomposition attributed 44% of the incidence increase to population growth, 48% to epidemiological change, and 7% to aging. Performance frontier analysis identified 659 preventable deaths annually (57% of total) if Saudi Arabia achieved benchmark efficiency. Ensemble forecasts project stabilization at 19.3 per 100,000 by 2050. Conclusions: The breast cancer burden in Saudi Arabia has increased significantly, driven primarily by true epidemiological change and population growth. Despite improving survival, significant preventable mortality persists, necessitating enhanced screening and treatment optimization.