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. 2024 Jul 2:74:102713.
doi: 10.1016/j.eclinm.2024.102713. eCollection 2024 Aug.

Global, regional, and national burden of female cancers in women of child-bearing age, 1990-2021: analysis of data from the global burden of disease study 2021

Ping Sun  1 , Chang Yu  2 , Limei Yin  1 , Yan Chen  1   3 , Zhaochen Sun  1   3 , TingTing Zhang  4 , Ping Shuai  1 , Kaihong Zeng  1 , Xiaoqin Yao  1 , Jianyu Chen  5 , Yuping Liu  1 , Zhengwei Wan  1
Affiliations

Global, regional, and national burden of female cancers in women of child-bearing age, 1990-2021: analysis of data from the global burden of disease study 2021

Ping Sun et al. EClinicalMedicine. .

Abstract

Background: The global status of women's health is underestimated, particularly the burden on women of child-bearing age (WCBA). We aim to investigate the pattern and trend of female cancers among WCBA from 1990 to 2021.

Methods: We retrieved data from the Global Burden of Disease Study (GBD) 2021 on the incidence and disability-adjusted life-years (DALYs) of four major female cancers (breast, cervical, uterine, and ovarian cancer) among WCBA (15-49 years) in 204 countries and territories from 1990 to 2021. Estimated annual percentage changes (EAPC) in the age-standardised incidence and DALY rates of female cancers, by age and socio-demographic index (SDI), were calculated to quantify the temporal trends. Spearman correlation analysis was used to examine the correlation between age-standardised rates and SDI.

Findings: In 2021, an estimated 1,013,475 new cases of overall female cancers were reported globally, with a significant increase in age-standardised incidence rate (EAPC 0.16%), and a decrease in age-standardised DALY rate (-0.73%) from 1990 to 2021. Annual increase trends of age-standardised incidence rate were observed in all cancers, except for that in cervical cancer. Contrary, the age-standardised DALY rate decreased in all cancers. Breast and cervical cancers were prevalent among WCBA worldwide, followed by ovarian and uterine cancers, with regional disparities in the burden of four female cancers. In addition, the age-standardised incidence rates of breast, ovarian, and uterine cancers basically showed a consistent upward trend with increasing SDI, while both the age-standardised incidence and DALY rates in cervical cancer exhibited downward trends with SDI. Age-specific rates of female cancers increased with age in 2021, with the most significant changes observed in younger age groups, except for uterine cancer.

Interpretation: The rising global incidence of female cancers, coupled with regional variations in DALYs, underscores the urgent need for innovative prevention and healthcare strategies to mitigate the burden among WCBA worldwide.

Funding: This study was supported by the Science Foundation for Young Scholars of Sichuan Provincial People's Hospital (NO. 2022QN44 and NO. 2022QN18); the Key R&D Projects of Sichuan Provincial Department of Science and Technology (NO. 2023YFS0196); the National Natural Science Foundation of China (No. 82303701).

Keywords: Breast cancer; Cervical cancer; Global burden of disease study; Ovarian cancer; Uterine cancer; Women of child-bearing age.

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Conflict of interest statement

All authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Age-standardised incidence and DALY rates in 2021, and their estimated annual percentage changes from 1990 to 2021 for female cancers, globally and by 21 GBD regions. Age-standardised rates of incidence and DALYs (A), and estimated annual percentage changes of age-standardised rates of incidence and DALYs (B). Female cancers include breast, cervical, ovarian, and uterine cancers. DALY, disability-adjusted life-years; EAPC, estimated annual percentage change; ASR, age-standardised rate.
Fig. 2
Fig. 2
National age-standardised incidence and DALY rates in 2021, and their estimated annual percentage changes from 1990 to 2021 for overall female cancers. Age-standardised rates of incidence (A) and DALYs (B). Estimated annual percentage changes of age-standardised incidence rate (C) and DALY rate (D). Female cancers include breast, cervical, ovarian, and uterine cancers. DALY, disability-adjusted life-years.
Fig. 3
Fig. 3
Numbers and proportions of incident cases and DALYs contributed by 21 GBD regions, for female cancers, in 2021. Numbers of incident cases (A) and DALYs (B) of each cancer. Proportions of incident cases (C) and DALYs (D) accounted for by each cancer. Female cancers include breast, cervical, ovarian, and uterine cancers. DALY, disability-adjusted life-years.
Fig. 4
Fig. 4
The cross-sectional (2021) and longitudinal trends (1990–2021) of incidence rate and DALY rate of female cancers throughout women of child-bearing age. Numbers and rates of incident cases (A) and DALYs (B) of female cancers. Percentage changes of incidence rate (C) and DALY rate (D) of female cancers. Female cancers include breast, cervical, ovarian, and uterine cancers. DALY, disability-adjusted life-years.
Fig. 5
Fig. 5
Age-standardised rates of incidence and DALYs of each female cancer, globally and for 21 GBD regions, by SDI (2021), from 1990 to 2021. Age-standardised incidence rates of breast cancer (A), cervical cancer (B), ovarian cancer (C), and uterine cancer (D), by SDI. Age-standardised DALY rates of breast cancer (E), cervical cancer (F), ovarian cancer (G), and uterine cancer (H), by SDI. Expected values with 95% CI, based on SDI and disease rates in all locations, are shown as a solid line and shaded area; 32 points are plotted for each region and show the observed age-standardised incidence or DALY rates for each year from 1990 to 2021. Points above the solid line represent a higher-than-expected burden, and those below the line show a lower-than-expected burden. Female cancers include breast, cervical, ovarian, and uterine cancers. DALY, disability-adjusted life-years; GBD, Global Burden of Diseases, Injuries, and Risk Factors Study. SDI, socio-demographic index.
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