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The burden of breast, cervical, and colon and rectum cancer in the Balkan countries, 1990–2019 and forecast to 2030

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Abstract
Background Despite effective prevention and control strategies, in countries of the Balkan region, cancers are the second leading cause of mortality, closely following circulatory system diseases. Objective To describe trends in the burden of breast, cervical, and colon and rectum cancer in the Balkan region and per country between 1990 and 2019, including a forecast to 2030.Methods We described the 2019 Global Burden of Disease (GBD) estimates for breast, cervical, and colon and rectum cancers in eleven Balkan countries over the period 1990-2019, including incidence, years lived with disability (YLD), years of life lost (YLL), and disability-adjusted life years (DALYs) rates per 100,000 population and accompanied 95% uncertainty interval. With the Autoregressive Integrated Moving Average, we forecasted these rates per country up to 2030.Results In the Balkan region, the highest incidence and DALYs rates in the study period were for colon and rectum, and breast cancers. Over the study period, the DALYs rates for breast cancer per 100,000 population were the highest in Serbia (reaching 670.84 in 2019) but the lowest in Albania (reaching 271.24 in 2019). In 2019, the highest incidence of breast cancer (85 /100,000) and highest YLD rate (64 /100,000) were observed in Greece. Romania had the highest incidence rates, YLD rates, DALY rates, and YLL rates of cervical cancer, with respective 20.59%, 23.39% 4.00%, and 3.47% increases for the 1990/2019 period, and the highest forecasted burden for cervical cancer in 2030. The highest incidence rates, YLD rates and DALY rates of colon and rectum cancers were continuously recorded in Croatia (an increase of 130.75%, 48.23%, and 63.28%, respectively), while the highest YLL rates were in Bulgaria (an increase of 63.85%). The YLL rates due to colon and rectum cancers are forecasted to progress by 2030 in all Balkan countries.Conclusion As most of the DALYs burden for breast, cervical, and colon and rectum cancer is due to premature mortality, the numerous country-specific barriers to cancer early detection and quality and care continuum should be a public priority of multi-stakeholder collaboration in the Balkan region.
Keywords
Burden of disease, European Burden of Disease Network, PREVENTION, MORTALITY

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MLA
Todorovic, Jovana, et al. “The Burden of Breast, Cervical, and Colon and Rectum Cancer in the Balkan Countries, 1990–2019 and Forecast to 2030.” ARCHIVES OF PUBLIC HEALTH, vol. 81, no. 1, BMC, 2023, doi:10.1186/s13690-023-01137-9.
APA
Todorovic, J., Stamenkovic, Z., Stevanovic, A., Terzic, N., Kissimova-Skarbek, K., Tozija, F., … Dis Collaborator Network, [missing]. (2023). The burden of breast, cervical, and colon and rectum cancer in the Balkan countries, 1990–2019 and forecast to 2030. ARCHIVES OF PUBLIC HEALTH, 81(1). https://doi.org/10.1186/s13690-023-01137-9
Chicago author-date
Todorovic, Jovana, Zeljka Stamenkovic, Aleksandar Stevanovic, Natasa Terzic, Katarzyna Kissimova-Skarbek, Fimka Tozija, Enkeleint A. Mechili, et al. 2023. “The Burden of Breast, Cervical, and Colon and Rectum Cancer in the Balkan Countries, 1990–2019 and Forecast to 2030.” ARCHIVES OF PUBLIC HEALTH 81 (1). https://doi.org/10.1186/s13690-023-01137-9.
Chicago author-date (all authors)
Todorovic, Jovana, Zeljka Stamenkovic, Aleksandar Stevanovic, Natasa Terzic, Katarzyna Kissimova-Skarbek, Fimka Tozija, Enkeleint A. Mechili, Brecht Devleesschauwer, Zorica Terzic-Supic, Milena Vasic, Vesna Bjegovic-Mikanovic, Milena Santric-Milicevic, Aaron Liew, Alexios Fotios Mentis, Alibek Mereke, Ana Catarina Sousa, Ana Laura Manda, Artemis Gkitakou, Balazs Adam, Bogdan Oancea, Bogdan Socea, Brigid Unim, Catalin Gabriel Smarandache, Che Henry Ngwa, Cornelia Melinda Adi Santoso, Daniel Sur, Dietrich Plass, Elena Pallari, Evangelia Nena, Federica Gazzelloni, Florian Fisher, Francesk Mulita, Giulia Collatuzzo, Grant Lewison, Grant Wyper, Hanen Samouda, Ionut Negoi, Jose Luis Penalvo, Juan Manuel Garcia Gonzalez, Juanita Haagsma, Klara Dokova, Lazslo Lorenzovici, Lorenzo Monasta, Miguel Reina Ortiz, Mihaela Hostiuc, Mika Gissler, Niko Speybroeck, Orsolya Varga, Peter Gaal, Polychronis Kostoulas, Ronan O’Caoimh, Sarah Cuscieri, Sonia Namorado, Tomislav Mestrovic, Vanessa Gorasso, Vesna Zadnik, Vildan Mevsim, Zubair Kabir, the COST Action 18218 participants Burden of Disease Collaborator Network, and [missing] Dis Collaborator Network. 2023. “The Burden of Breast, Cervical, and Colon and Rectum Cancer in the Balkan Countries, 1990–2019 and Forecast to 2030.” ARCHIVES OF PUBLIC HEALTH 81 (1). doi:10.1186/s13690-023-01137-9.
Vancouver
1.
Todorovic J, Stamenkovic Z, Stevanovic A, Terzic N, Kissimova-Skarbek K, Tozija F, et al. The burden of breast, cervical, and colon and rectum cancer in the Balkan countries, 1990–2019 and forecast to 2030. ARCHIVES OF PUBLIC HEALTH. 2023;81(1).
IEEE
[1]
J. Todorovic et al., “The burden of breast, cervical, and colon and rectum cancer in the Balkan countries, 1990–2019 and forecast to 2030,” ARCHIVES OF PUBLIC HEALTH, vol. 81, no. 1, 2023.
@article{01H8RRCS38XQ6BNJQ3Y5J83W1Z,
  abstract     = {{Background Despite effective prevention and control strategies, in countries of the Balkan region, cancers are the second leading cause of mortality, closely following circulatory system diseases. Objective To describe trends in the burden of breast, cervical, and colon and rectum cancer in the Balkan region and per country between 1990 and 2019, including a forecast to 2030.Methods We described the 2019 Global Burden of Disease (GBD) estimates for breast, cervical, and colon and rectum cancers in eleven Balkan countries over the period 1990-2019, including incidence, years lived with disability (YLD), years of life lost (YLL), and disability-adjusted life years (DALYs) rates per 100,000 population and accompanied 95% uncertainty interval. With the Autoregressive Integrated Moving Average, we forecasted these rates per country up to 2030.Results In the Balkan region, the highest incidence and DALYs rates in the study period were for colon and rectum, and breast cancers. Over the study period, the DALYs rates for breast cancer per 100,000 population were the highest in Serbia (reaching 670.84 in 2019) but the lowest in Albania (reaching 271.24 in 2019). In 2019, the highest incidence of breast cancer (85 /100,000) and highest YLD rate (64 /100,000) were observed in Greece. Romania had the highest incidence rates, YLD rates, DALY rates, and YLL rates of cervical cancer, with respective 20.59%, 23.39% 4.00%, and 3.47% increases for the 1990/2019 period, and the highest forecasted burden for cervical cancer in 2030. The highest incidence rates, YLD rates and DALY rates of colon and rectum cancers were continuously recorded in Croatia (an increase of 130.75%, 48.23%, and 63.28%, respectively), while the highest YLL rates were in Bulgaria (an increase of 63.85%). The YLL rates due to colon and rectum cancers are forecasted to progress by 2030 in all Balkan countries.Conclusion As most of the DALYs burden for breast, cervical, and colon and rectum cancer is due to premature mortality, the numerous country-specific barriers to cancer early detection and quality and care continuum should be a public priority of multi-stakeholder collaboration in the Balkan region.}},
  articleno    = {{156}},
  author       = {{Todorovic, Jovana and Stamenkovic, Zeljka and Stevanovic, Aleksandar and Terzic, Natasa and Kissimova-Skarbek, Katarzyna and Tozija, Fimka and Mechili, Enkeleint A. and Devleesschauwer, Brecht and Terzic-Supic, Zorica and Vasic, Milena and Bjegovic-Mikanovic, Vesna and Santric-Milicevic, Milena and Liew, Aaron and Mentis, Alexios Fotios and Mereke, Alibek and Sousa, Ana Catarina and Manda, Ana Laura and Gkitakou, Artemis and Adam, Balazs and Oancea, Bogdan and Socea, Bogdan and Unim, Brigid and Smarandache, Catalin Gabriel and Ngwa, Che Henry and Santoso, Cornelia Melinda Adi and Sur, Daniel and Plass, Dietrich and Pallari, Elena and Nena, Evangelia and Gazzelloni, Federica and Fisher, Florian and Mulita, Francesk and Collatuzzo, Giulia and Lewison, Grant and Wyper, Grant and Samouda, Hanen and Negoi, Ionut and Penalvo, Jose Luis and Gonzalez, Juan Manuel Garcia and Haagsma, Juanita and Dokova, Klara and Lorenzovici, Lazslo and Monasta, Lorenzo and Ortiz, Miguel Reina and Hostiuc, Mihaela and Gissler, Mika and Speybroeck, Niko and Varga, Orsolya and Gaal, Peter and Kostoulas, Polychronis and O’Caoimh, Ronan and Cuscieri, Sarah and Namorado, Sonia and Mestrovic, Tomislav and Gorasso, Vanessa and Zadnik, Vesna and Mevsim, Vildan and Kabir, Zubair and participants Burden of Disease Collaborator Network, the COST Action 18218 and Dis Collaborator Network, [missing]}},
  issn         = {{0778-7367}},
  journal      = {{ARCHIVES OF PUBLIC HEALTH}},
  keywords     = {{Burden of disease,European Burden of Disease Network,PREVENTION,MORTALITY}},
  language     = {{eng}},
  number       = {{1}},
  pages        = {{15}},
  publisher    = {{BMC}},
  title        = {{The burden of breast, cervical, and colon and rectum cancer in the Balkan countries, 1990–2019 and forecast to 2030}},
  url          = {{http://doi.org/10.1186/s13690-023-01137-9}},
  volume       = {{81}},
  year         = {{2023}},
}

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