For the first time ever, the World Health Organization (WHO) has published global 5-year breast cancer survival estimates for women diagnosed with breast cancer between 2017 and 2021 for all its 194 Member States. Published by Girardi et al in Nature Medicine, these estimates provide a baseline for every country to monitor progress towards achieving the WHO Global Breast Cancer Initiative (GBCI) targets.
The GBCI aims to reduce premature breast cancer mortality by 2.5% per year, saving 2.5 million lives by 2040. Breast cancer is the most common cancer among women in 158 countries. In 2024, it resulted in approximately 694 000 deaths globally—70% in low- and middle-income countries. An estimated 8 million women, mostly in high-income countries, were living with the disease.
According to the newly published analysis, the global median 5-year net survival for women diagnosed during the period from 2017 to 2021 was 77.8%. The findings reflect stark differences across WHO regions, with survival estimates ranging from as low as 39.1% in the African region to 88.5% in the region of the Americas and 84.0% in the European region. Survival was also closely linked to national income. In low-income countries, the median 5-year survival was 41.9%, rising to 60.1% in lower–middle-income countries, 78.7% in upper–middle-income countries, and 87.3% in high-income countries.
“Breast cancer survival is an important measure of how well a country's health system detects and treats breast cancer. It reflects the combined impact of early detection, linked to timely diagnosis and effective multimodality treatment, and the quality of care they receive, supporting countries to assess their progress, and identifying areas for improvement in their national breast cancer control efforts,” said Alarcos Cieza, MD, PhD, Unit Head, Management of Noncommunicable Diseases, Department of Noncommunicable Diseases and Mental Health at WHO headquarters.
The analysis used a statistical model that synthesized observed survival data from cancer registries in the 67 out of 194 WHO Member States where these data were available, alongside covariates such as stage at diagnosis, access to cancer medicines, radiotherapy and mammography capacity, and overall adult mortality rates. Among the 36 fragile and conflict-affected states, only 2 had any observed data, highlighting inequities and critical gaps in population-based cancer surveillance worldwide.
Stage at diagnosis was a key predictor of long-term survival for breast cancer, with lower survival rates observed in countries where breast cancer was diagnosed in more advanced stages. The findings reinforce the importance of all three GBCI operational pillars: ensuring that 60% of invasive breast cancers are diagnosed at stage I or II; achieving timely diagnosis within 60 days of presentation; and completion of multimodality treatment for 80% or more for patients where it is indicated.
WHO worked with Member states through a formal two-phase consultation process to review methodology, preliminary estimates, and incorporate the available observed national data, while ensuring transparency and country ownership.
DISCLOSURE: The study was funded by the Republic of Korea, St. Jude Children’s Research Hospital, and the City Cancer Challenge. For full disclosures of the study authors, visit nature.com.
