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