Breast cancer rehabilitation in the Russian Federation vs. Germany, Kazakhstan, Poland, Finland, and Czechia: assessment of nonfatal burden (1990–2021)

Background. Breast cancer (BC) is the leading cause of oncological morbidity among women in both the Russian Federation and globally. While the BC mortality rate is declining due to significant advances in modern therapy, an increasing number of survivors require long-term rehabilitation for lymphedema, pain, and cognitive and psychological impairment. Compared with other countries, a quantitative assessment of the need for BC rehabilitation in Russia in comparison remains insufficient.

Objective: To assess the dynamics of non-fatal burden of BC in women in Russia and compare the results with indicators from Germany, Kazakhstan, Poland, Finland, and Czechia (1990–2021), while also providing a forecast up to 2030.

Material and methods. Secondary analysis of open data from Global Burden of Disease Study 2021 (GBD 2021) and Global Сancer Statistics (GLOBOCAN) 2022 was conducted. The study examined rates of years lived with disability (YLD) per 100,000 people, categorized by age group (15–49, 50–69, ≥70, and all ages), as well as the age-standardized incidence rate (ASIR) and age-standardized mortality rate (ASMR). The estimated annual percentage change (EAPC) was calculated for the period from 1990 to 2021. A forecast was compiled for 2030 using the EAPC extrapolation method.

Results. Over the period from 1990 to 2021, the YLD for BC increased in all analyzed countries. Poland and Russia experienced the largest relative increases (+96.2% and +84.4%, respectively), whereas Kazakhstan demonstrated the smallest increase (+9.1%). The absolute YLD value in Russia (60.86 per 100,000) is substantially lower than in Germany (142.24) and Finland (129.36). Combined with a lower five-year survival rate (65% vs. 85–87%), this reflects a “rehabilitation accumulation deficit”. In the 50–69 age group, Russia shows continued YLD growth while Western European countries demonstrate stabilization. By 2030, the YLD rate in Russia is expected to reach 72.7 per 100,000, with an annual EAPC of +2.0%.

Conclusion. In Russia, rehabilitation needs for BC survivors are rapidly increasing. Meanwhile, the existing rehabilitation infrastructure fails to adequately address the growing number of non-fatal cases. Therefore, a scaled-up version of the German model adapted to Russian conditions is required.

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