Abstract
Objective To evaluate the epidemiological trends and patterns
of cervical cancer, uterine cancer and ovarian cancer in China in 1990
and 2019.
Design Systematical and updated worldwide epidemiological
study.
Setting Global Burden of Disease (GBD) Study 2019.
Population or Sample . Chinese population was obtained from
World Health Organization (WHO) World Standard Population Distribution
(2000-2025) and the United Nations World Population Prospects 2019
Revision.
Methods Data were extracted from the Global Burden of Diseases,
Injuries, and Risk Factors Study 2019. GBD methodology was used to
estimate the burden of gynecological malignancies in China, including
cervical cancer, uterine cancer and ovarian cancer.
Main Outcome Measures The incidence, mortality,
disability-adjusted life-years (DALYs), and estimated annual percentage
change (EAPC) were systematically analyzed. We additionally predicted
the incidence and mortality of gynecological malignancies from 2020 to
2030.
Results From 1990 to 2019, the numbers of incidence cases,
deaths and DALYs of cervical cancer, uterine cancer and ovarian cancer
all significantly increased. The EAPCs in age-standardized incidence
rate (ASIR) of three cancers were 1.61 (95% CI: 1.35, 1.88), 1.26 (95%
CI: 0.58, 1.94) and 1.88 (95% CI: 1.79, 1.98). From 2020 to 2030, the
predicted numbers of incident cases and deaths of gynecological
malignancies should continue to increase, and the incidences of uterine
cancer would expect to exceed cervical cancer in 2030.
Conclusions In China, the numbers of new cases and deaths of
gynecological malignancies will continue to increase in the next ten
years. Reducing the prevalence of gynecological malignancies should be
prioritized in future work.
Funding The National Key Research and Development Program of
China (No.2021YFF1201101)
Keywords Burden, gynecological malignancies, China, global
burden of disease study
Introduction
Gynaecological malignancies are the leading causes of premature death
and disability for women worldwide, mainly including cervical cancer,
uterine cancer and ovarian cancer. There were approximately 1,309,165
new cases and 609,377 deaths of
gynaecological malignancies worldwide
in 2018. Cervical cancer is the
fourth most frequently diagnosed cancer and the fourth leading cause of
cancer death in women, with an estimated 604,000 new cases and 342,000
deaths worldwide in 20201. Cervical cancer represents
a major global health challenge. Uterine cancer is the sixth most
commonly diagnosed cancer in women, with 417,000 new cases and 97,000
deaths in 2020.1 Uterine cancer mostly affects
post-menopausal women. For patients with advanced disease, with lymph
node invasion or metastasis, the 5-year overall survival is only 50%
and 20%, respectively.2 Ovarian cancer is the most
lethal of the gynecologic malignancies with highest mortality rate among
all gynecological malignant tumors. Although progress has been made in
the diagnosis, prevention, screening and treatment of these malignancies
over the past decades, many issues remain to be unsolved, such as
chemoresistance, metastasis, recurrence, and family financial
burden.3,4
Gynecological malignancies are the
serious public health problem for women in China. These malignancies put
the heavy burden on women, family and society in China, so there is an
urgent need for comprehensive understanding of the epidemic trends and
patterns of gynecological cancer in China. We conducted this study to
investigate and characterize the temporal trends and patterns in China
over 30 years based on Global Burden of Disease (GBD) 2019, and predict
incidence and mortality of gynecological malignancies from 2020 to 2030.
Findings of this study will provide certain enlightenment for the
etiological research of these cancers in China, measure the progress of
specific treatments, help policymakers allocate resources and formulate
relevant medical policies and opinions in the future.
Methods