Breast Cancer Mortality Declines in Spain, But Global Disparities Remain

The mortality rate from breast cancer in Spain decreased by approximately 42% between 1990 and 2023, according to a study published on March 2, 2026, in The Lancet Oncology as part of the Global Burden of Diseases (GBD) 2023 research. In 2023, roughly 13.9 women per 100,000 died from breast cancer in Spain, down from about 24 per 100,000 in 1990. This improvement reflects advancements in prevention, diagnosis, and treatment, even as the population has grown and aged.

Rising Incidence, Improved Survival

Even as mortality rates have fallen, the number of breast cancer diagnoses in Spain has increased significantly—by 65% to around 29,400 new cases in 2023. This rise is largely attributed to a larger population and an aging demographic. However, when adjusted for these factors, the individual risk of developing the disease has barely changed and has even slightly decreased (by 5%). This indicates that more cases are being detected, but proportionally, individual risk hasn’t increased, and survival rates have demonstrably improved.

Global Trends and Disparities

Spain’s positive trend aligns with the broader pattern observed in high-income countries, where standardized mortality rates have decreased by an average of 29.9% due to successful screening programs, earlier diagnoses, and improved treatments. However, breast cancer remains a leading cause of cancer-related mortality among women worldwide, accounting for nearly one in four new female cancer cases globally.

The study highlights a stark contrast between high- and low-income countries. While mortality rates are declining in wealthier regions, they have increased by 99.3% in low-income countries since 1990, indicating deficiencies in healthcare systems, late detection, and limited access to life-saving therapies. Without urgent global interventions, breast cancer diagnoses are projected to rise from 2.3 million cases in 2023 to 3.56 million in 2050, resulting in approximately 1.37 million deaths.

Preventable Risk Factors

The research emphasizes the significant role of preventable risk factors in breast cancer development. The analysis found that 28.3% of the global burden of the disease (measured in disability-adjusted life years, or DALYs) is attributable to modifiable risks, including dietary factors (such as high red meat consumption), smoking, high fasting plasma glucose levels, a high body mass index, frequent alcohol consumption, and a sedentary lifestyle.

The Path Forward

The authors conclude that achieving equitable survival rates for all women requires a combination of aggressive prevention strategies, well-functioning healthcare systems capable of early diagnosis and comprehensive treatment, and affordable access to cancer care.

Expert Perspectives

Marina Pollán, cancer epidemiologist and general director of the Carlos III Health Institute, noted that the study may underestimate cases in Spain—citing a figure of 35,540 from the Spanish Cancer Information System (SIEC) compared to the study’s 29,400—and overestimate mortality. However, she emphasized the study’s importance in highlighting the global disease burden, disparities in life expectancy between countries, and the role of modifiable risk factors.

Alejandro Pérez Fidalgo, an oncologist at the Valencia Clinical Health Research Institute (INCLIVA), praised the GBD study as one of the largest and most ambitious projects quantifying population health loss worldwide. He stated that the data for Spain reflects positively on the country’s healthcare system and its approach to combating breast cancer between 1990 and 2023, with the recorded decline exceeding the average for rich countries. “That there are many more new cases and, even so, mortality falls by almost 42% in the same period of time is a great health milestone for which we should congratulate ourselves.”