过去四十年中的众多研究已揭示出乳腺癌筛查（BCS）可显著降低乳腺癌（BC）的致死率。然而，在金砖国家和其他国家（BRICS-plus）中，BCS与乳腺癌病例致死率和残疾率之间的关联仍不明确。本研究从国家和经济角度考察了不同BCS方法与年龄标化死亡率、病例致死率和调整后的失能生命年（DALYs）率的关联，以及与其他生物学和社会人口学风险变量的关联。本生态学研究应用混合效应多层次回归模型，在全球疾病负担2019年对女性年龄标化乳腺癌死亡率、发病率和DALYs率的数据基础上，将国家/地区的BCS可及性数据（相对于无此类计划或只有试点计划）和BCS类型数据（仅自我乳房检查（SBE）和/或临床乳房检查（CBE）【SBE/CBE】与SBE/CBE和/或乳房摄影筛查（MM和/或SBE/CBE】与SBE/CBE和/或乳房摄影与/或超声（DMM/US【以及以往测试】】的数据）在金砖国家和其他国家（BRICS-plus）进行了分析。相较于金砖国家和其他国家（BRICS-plus）的自我/临床乳房检查（SBE/CBE），更复杂的BCS方案可及性是降低死亡率的最重要预测因子【MM和/或SBE/CBE：-2.64，p<0.001；DMM/US和/或以往测试：-1.40，p<0.001】。在金砖国家和其他国家（BRICS-plus），心血管疾病的存在、高BMI、二手烟和主动吸烟都导致了乳腺癌死亡率和DALYs率的增加。金砖国家和其他国家（BRICS-plus）实施全国范围的乳腺癌筛查计划时，中高收入地区的乳腺癌年龄标化死亡率、病例致死率和DALYs率明显低于低收入地区。乳房摄影（数字或传统）和BCS可及性与金砖国家和其他国家（BRICS-plus）的乳腺癌负担相关联，并存在地区差异。鉴于以往因果研究的高质量证据，这些发现进一步支持乳房摄影筛查在国家层面上在乳腺癌筛查中的预防作用。对与BCS相关的风险因素进行干预，还可以进一步减少与乳腺癌相关的疾病负担。© 2023. BioMed Central Ltd., part of Springer Nature.

Numerous studies over the past four decades have revealed that breast cancer screening (BCS) significantly reduces breast cancer (BC) mortality. However, in BRICS-plus countries, the association between BCS and BC case fatality and disability are unknown. This study examines the association of different BCS approaches with age-standardized mortality, case-fatality, and disability-adjusted life years (DALYs) rates, as well as with other biological and sociodemographic risk variables, across BRICS-plus from a national and economic perspective.In this ecological study applying mixed-effect multilevel regression models, a country-specific dataset was analyzed by combining data from the Global Burden of Disease study 2019 on female age-standardized BC mortality, incidence, and DALYs rates with information on national/regional BCS availability (against no such program or only a pilot program) and BCS type (only self-breast examination (SBE) and/or clinical breast examination (CBE) [SBE/CBE] versus SBE/CBE with mammographic screening availability [MM and/or SBE/CBE] versus SBE/CBE/mammographic with digital mammography and/or ultrasound (US) [DMM/US and/or previous tests] in BRICS-plus countries.Compared to self/clinical breast examinations (SBE/CBE) across BRICS-plus, more complex BCS program availability was the most significant predictor of decreased mortality [MM and/or SBE/CBE: - 2.64, p < 0.001; DMM/US and/or previous tests: - 1.40, p < 0.001]. In the BRICS-plus, CVD presence, high BMI, second-hand smoke, and active smoking all contributed to an increase in BC mortality and DALY rate. High-income and middle-income regions in BRICS-plus had significantly lower age-standardized BC mortality, case-fatality, and DALYs rates than low-income regions when nationwide BC screening programs were implemented.The availability of mammography (digital or traditional) and BCS is associated with breast cancer burden in BRICS-plus countries, with regional variations. In light of high-quality evidence from previous causal studies, these findings further support the preventive role of mammography screening for BCS at the national level. Intervening on BCS related risk factors may further reduce the disease burden associated with BC.© 2023. BioMed Central Ltd., part of Springer Nature.