DALYs rates and proportions attributable to risk factors for gynecological malignancies from 1990 to 2019
In all age-specific groups, the DALYs rates of cervical cancer attributed to unsafe sexual activity were the highest, and fortunately, the DALYs rates attributable to unsafe sexual activity showed a downward trend in recent years. The DALYs rates of cervical cancer due to smoking showed a downward trend in above 60-year-old groups. The DALYs rates of uterine cancer due to high body-mass index were higher between 50 and 69 years. The DALYs rates of ovarian cancer attributable to high body-mass index, high fasting plasma glucose and occupational asbestos exposure had an upward trend from 1990 to 2019.
The DALYs proportion of cervical cancer attributable to unsafe sexual activity was 100% continuously, and smoking’s contribution descended in 2019 compared to 1990. Proportions of DALYs attributable to high body-mass index for uterine cancer and ovarian cancer were higher in 2019 than in 1990 in all age-specific groups. The high fasting plasma glucose was the most significant contribution to ovarian cancer, accounting for more than 6% in above 60-year-old women. The proportion of DALYs attributable to occupational asbestos exposure was slightly lower in 2019 than in 1990 (Figure 3).
Predictions ofincidence and mortality of gynecological malignancies from 2020 to 2030
Based on GBD data of gynecological malignancies from 1990 to 2019 in China, we predicted the incident cases and deaths in the next eleven years (Figure 4). The numbers of incident cases and deaths of cervical cancer, uterine cancer and ovarian cancer should continue to increase from 2020 to 2030. The predicted new cases of uterine cancer have the steepest rising slope, which is expected to exceed the cases of cervical cancer in 2030. Meanwhile, the growth of uterine cancer deaths also had the steepest slope, followed by ovarian cancer and cervical cancer. In 2030, the overall new cases of cervical cancer, uterine cancer and ovarian cancer should increase to 123,902, 132,118 and 72,488, respectively (Figure 4A). And the overall deaths of cervical cancer, uterine cancer and ovarian cancer should increase to 59,145, 18,571 and 45,680, respectively (Figure 4B).
We further predicted the age-standardized incidence rate and death rate of gynecological malignancies from 2020 to 2030 (Figure 5). Age-standardized rates of incidence and mortality of cervical cancer should show a downward trend (Figure 5A and 5B). The age-standardized incidence rate of uterine cancer should show a slow upward trend and the death rate of uterine cancer remain stabilized trend (Figure 5C and 5D). Seriously, the age-standardized rates of incidence and mortality of ovarian cancer should show an upward trend (Figure 5E and 5F).