The burden of breast cancer among women is significant in Asia-Pacific, where it is the cancer with the highest incidence and mortality rates in the WHO South-East Asia Region and the highest incidence and second highest mortality rates in WHO Western Pacific Region. In 2022, approximately 575 000 women in Western-Pacific Region and 314 000 women in South-East Asia Region were expected to be newly diagnosed with breast cancer and over 129 000 women in Western Pacific Region and approximately 143 000 women in South-East Region died of the disease (Bray et al., 2024[1]). Several factors are known to increase the risk of breast cancer, such as increasing age, obesity, harmful use of alcohol, family history of breast cancer, history of radiation exposure, reproductive history, tobacco use and postmenopausal hormone therapy (WHO, 2024[2]).
Age‑standardised breast cancer incidence rate varied by over 8‑fold across countries in Asia-Pacific in 2022. The rate was below 20 new cases per 100 000 women in Mongolia, Nepal and Bangladesh while it was 94 new cases per 100 000 women in New Zealand and over 100 new cases per 100 000 in Australia. The average rate was low for lower-middle countries in the region (31 per 100 000) and upper-middle-income countries (44 per 100 000). However, the average rate for high-income countries in Asia-Pacific was high at 76 per 100 000, although this was slightly lower than the OECD average of 78 per 100 000 (Figure 7.7).
Over the recent decades, age‑standardised incidence rates have risen quickly in China, India, Thailand, Japan and Korea. On the other hand, in Australia and New Zealand, with highest incidence rates, incidence rates have increased more slowly in recent years (IARC, 2024[3]).
Early diagnosis is a key to tackling breast cancer. The WHO recommends organising population-based mammography screening programmes (WHO, 2014[4]). Mammography screening rate is relatively high in countries in which national screening programme was introduced a few decades ago such as New Zealand and Korea at over 60% (Figure 7.8). Japan introduced national breast cancer screening programme in 1987, and Australia and New Zealand introduced it in the 1990s (OECD, 2013[5]; IARC, 2016[6]) and Korea and Singapore around 2000.
By contrast, less than one in four women in target age underwent mammography screening in Brunei Darussalam, China and Macau (China) (Figure 7.8). Countries and territories with low mammography screening rates either introduced national breast cancer screening programme only recently such as China in 2010 (Zhang et al., 2021[7]) and Malaysia in 2012 (Mohd Said and Sutan, 2021[8]), is rolling out the screening programme as done in Brunei Darussalam (Ministry of Health Brunei Darussalam, 2020[9]), or piloting a screening programme like in Hong Kong (China) (The Goverment of the Hong Kong Special Administrative Region, 2021[10]). Few other countries in Asia-Pacific also rolled out (in Indonesia in 2015) or are rolling out national programme (in Viet Nam) (Wahidin, 2018[11]; Pham et al., 2019[12])
Countries which monitor uptake of breast cancer screening programme observed a decline in the uptake of mammography screening in 2020 as they stopped cancer screening programmes in the beginning of the COVID‑19 pandemic. In most countries, mammography screening rates are still low compared to those before the pandemic, and the decline still remained large at around 7 percentage points in Australia, New Zealand and Korea (Figure 7.8).
In 2020, mortality rates from breast cancer, reflecting effectiveness in early detection and treatment, and underlying trends in incidence, prevalence and survival, varied over 12‑fold between countries and territories in the Asia-Pacific region. The rate was lowest in Mongolia at 3 deaths per 100 000 women and the highest in Fiji at 39 per 100 000 women. While average age‑standardised incidence rate was lower, the average age‑standardised mortality rate was higher for upper-middle-, lower-middle- and low-income countries than in high income countries in the region (Figure 7.9). While mortality rates are decreasing in some high-income countries such as Australia, New Zealand and Singapore, they are increasing in other countries including the Philippines, Malaysia, Japan and Korea, suggesting needs to further improve early detection and treatment of breast cancer in these countries.
