Breast cancer incidence in Indonesia: a sex-disaggregated analysis using WHO health equity assessment toolkit data

Abstract Introduction Breast cancer is the most common cancer among women globally, with notable disparities in incidence between sexes, particularly in low and middle-income countries. Understanding these disparities is essential for tackling health inequities, particularly in Indonesia, where acce...

Full description

Saved in:
Bibliographic Details
Main Authors: Augustus Osborne, Qorinah Estiningtyas Sakilah Adnani, Bright Opoku Ahinkorah
Format: Article
Language:English
Published: BMC 2025-06-01
Series:BMC Cancer
Subjects:
Online Access:https://doi.org/10.1186/s12885-025-14332-4
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849724787785465856
author Augustus Osborne
Qorinah Estiningtyas Sakilah Adnani
Bright Opoku Ahinkorah
author_facet Augustus Osborne
Qorinah Estiningtyas Sakilah Adnani
Bright Opoku Ahinkorah
author_sort Augustus Osborne
collection DOAJ
description Abstract Introduction Breast cancer is the most common cancer among women globally, with notable disparities in incidence between sexes, particularly in low and middle-income countries. Understanding these disparities is essential for tackling health inequities, particularly in Indonesia, where access to screening and treatment is spatially inconsistent. This study examined the trends and disparities in breast cancer incidence in Indonesia from 2000 to 2019, utilizing sex-disaggregated data from the World Health Organization’s Health Equity Assessment Toolkit (HEAT). Methods Age-standardized breast cancer incidence rates (per 100,000 population) from the WHO HEAT were measured. The HEAT platform sources data from the Institute for Health Metrics and Evaluation (IHME), which compiles data from national cancer registries and health surveys. Four inequality indicators were calculated to assess the absolute and relative differences in breast cancer incidence between males and females: Difference, Ratio, Population Attributable Fraction, and Population Attributable Risk. All estimates were presented with Confidence Intervals (CI). Results Between 2000 and 2019, the age-standardized incidence of breast cancer in Indonesia declined from 19.1 to 16.0 per 100,000 population. Nonetheless, considerable sex disparities remained. In 2019, the incidence rate for females was 37.4 (CI: 29.0–48.6), whereas for males it was 0.4 (CI: 0.2–0.5). The absolute difference in incidence between sexes rose from 31.0 in 2000 to 37.1 in 2019. The relative disparity persisted, with females being over 100 times more predisposed to breast cancer than males (ratio = 104.4 in 2019). The population attributable fraction and population attributable risk values continuously demonstrated that almost all breast cancer cases were associated with females. PAF values fluctuated from − 98.6% in 2000 to -98.1% in 2019. Conclusions The incidence of breast cancer in Indonesia is declining; yet, sex disparities remain, with females bearing a disproportionately greater burden. These findings underscore the need for targeted public health strategies, including expanded access to breast cancer screening programs, public awareness campaigns to promote early detection, and improved availability of diagnostic and treatment services tailored to women. Future research ought to identify and mitigate female-specific risk factors, such as hormonal and reproductive factors, and lifestyle impacts, to enhance prevention measures, are critical for reducing these disparities and improving health outcomes.
format Article
id doaj-art-bdcf4fca9f2b403ea6c6c3d5bf5d5df2
institution DOAJ
issn 1471-2407
language English
publishDate 2025-06-01
publisher BMC
record_format Article
series BMC Cancer
spelling doaj-art-bdcf4fca9f2b403ea6c6c3d5bf5d5df22025-08-20T03:10:38ZengBMCBMC Cancer1471-24072025-06-012511810.1186/s12885-025-14332-4Breast cancer incidence in Indonesia: a sex-disaggregated analysis using WHO health equity assessment toolkit dataAugustus Osborne0Qorinah Estiningtyas Sakilah Adnani1Bright Opoku Ahinkorah2Institute for DevelopmentDepartment of Public Health, Faculty of Medicine, Universitas PadjadjaranFaculty of Health and Medical Sciences, the University of AdelaideAbstract Introduction Breast cancer is the most common cancer among women globally, with notable disparities in incidence between sexes, particularly in low and middle-income countries. Understanding these disparities is essential for tackling health inequities, particularly in Indonesia, where access to screening and treatment is spatially inconsistent. This study examined the trends and disparities in breast cancer incidence in Indonesia from 2000 to 2019, utilizing sex-disaggregated data from the World Health Organization’s Health Equity Assessment Toolkit (HEAT). Methods Age-standardized breast cancer incidence rates (per 100,000 population) from the WHO HEAT were measured. The HEAT platform sources data from the Institute for Health Metrics and Evaluation (IHME), which compiles data from national cancer registries and health surveys. Four inequality indicators were calculated to assess the absolute and relative differences in breast cancer incidence between males and females: Difference, Ratio, Population Attributable Fraction, and Population Attributable Risk. All estimates were presented with Confidence Intervals (CI). Results Between 2000 and 2019, the age-standardized incidence of breast cancer in Indonesia declined from 19.1 to 16.0 per 100,000 population. Nonetheless, considerable sex disparities remained. In 2019, the incidence rate for females was 37.4 (CI: 29.0–48.6), whereas for males it was 0.4 (CI: 0.2–0.5). The absolute difference in incidence between sexes rose from 31.0 in 2000 to 37.1 in 2019. The relative disparity persisted, with females being over 100 times more predisposed to breast cancer than males (ratio = 104.4 in 2019). The population attributable fraction and population attributable risk values continuously demonstrated that almost all breast cancer cases were associated with females. PAF values fluctuated from − 98.6% in 2000 to -98.1% in 2019. Conclusions The incidence of breast cancer in Indonesia is declining; yet, sex disparities remain, with females bearing a disproportionately greater burden. These findings underscore the need for targeted public health strategies, including expanded access to breast cancer screening programs, public awareness campaigns to promote early detection, and improved availability of diagnostic and treatment services tailored to women. Future research ought to identify and mitigate female-specific risk factors, such as hormonal and reproductive factors, and lifestyle impacts, to enhance prevention measures, are critical for reducing these disparities and improving health outcomes.https://doi.org/10.1186/s12885-025-14332-4Breast cancerIndonesiaHealth equitySex disparitiesWHO HEAT
spellingShingle Augustus Osborne
Qorinah Estiningtyas Sakilah Adnani
Bright Opoku Ahinkorah
Breast cancer incidence in Indonesia: a sex-disaggregated analysis using WHO health equity assessment toolkit data
BMC Cancer
Breast cancer
Indonesia
Health equity
Sex disparities
WHO HEAT
title Breast cancer incidence in Indonesia: a sex-disaggregated analysis using WHO health equity assessment toolkit data
title_full Breast cancer incidence in Indonesia: a sex-disaggregated analysis using WHO health equity assessment toolkit data
title_fullStr Breast cancer incidence in Indonesia: a sex-disaggregated analysis using WHO health equity assessment toolkit data
title_full_unstemmed Breast cancer incidence in Indonesia: a sex-disaggregated analysis using WHO health equity assessment toolkit data
title_short Breast cancer incidence in Indonesia: a sex-disaggregated analysis using WHO health equity assessment toolkit data
title_sort breast cancer incidence in indonesia a sex disaggregated analysis using who health equity assessment toolkit data
topic Breast cancer
Indonesia
Health equity
Sex disparities
WHO HEAT
url https://doi.org/10.1186/s12885-025-14332-4
work_keys_str_mv AT augustusosborne breastcancerincidenceinindonesiaasexdisaggregatedanalysisusingwhohealthequityassessmenttoolkitdata
AT qorinahestiningtyassakilahadnani breastcancerincidenceinindonesiaasexdisaggregatedanalysisusingwhohealthequityassessmenttoolkitdata
AT brightopokuahinkorah breastcancerincidenceinindonesiaasexdisaggregatedanalysisusingwhohealthequityassessmenttoolkitdata