Breast cancer burden risk attribution and productivity loss in Chinese women aged 25 to 49

Abstract

Breast cancer among Chinese women aged 25–49 years has substantial clinical and societal consequences. We integrated Global Burden of Disease (GBD) 2023 estimates for 1990–2023 with Global Cancer Observatory (GLOBOCAN) 2022, United Nations population projections, International Labour Organization labour-force participation, and World Bank indicators. Incident cases rose from 50,064 to 87,221, while the weighted death rate declined from 9.25 to 4.72 per 100,000. Demographic changes explained 63.0% of additional cases. In exploratory extreme gradient boosting (XGBoost) analyses interpreted with SHapley Additive exPlanations (SHAP), the fasting-plasma-glucose-related population attributable fraction (PAF) ranked first in several formulations but weakened after removing age and temporal structure; the selected high-body-mass-index (BMI) PAF series was constant at zero and unrankable. Potential mortality-related productivity loss was US$6.161 billion in 2023. Status-quo projections suggested increasing incidence through 2050 with very wide uncertainty, supporting surveillance and individual-level validation rather than immediate screening policy changes.