Trends and projections of global gynaecological cancer burden: age-period-cohort insights from Global Burden of Disease 2021

Abstract

Background: Gynaecological cancers (GCs), including ovarian cancer (OC), cervical cancer (CC), breast cancer (BC), and uterine cancer (UC) cancers are a significant group of malignancies affecting the female reproductive system and pose a serious global health threat. This study analyzes the global and regional burden of OC, CC, BC, and UC from 1990 to 2021, utilizing the Global Burden of Disease (GBD) 2021 data and advanced modeling approaches. Methods: Our study utilized the GBD 2021 to investigate the trends of GCs globally, regionally, and in the country. The age-period-cohort (APC) model to assess the independent effects of age, period, and cohort. Additionally, autoregressive integrated moving average (ARIMA) and Bayesian age-period-cohort (BAPC) models were used to forecast GC trends over the next 30 years. Results: In 2021, BC had the highest global incident cases, with 2,082,737(95% UI: 1,940,351 to 2,225,083), deaths at 660,925 (95% UI: 609,171 to 707,182), and disability-adjusted life years (DALYs) at 20,254,802 (95% UI: 18,963,376 to 21,574,429). From 1990 and 2021, the age-standardized incidence rates (ASIR), age-standardized mortality rates (ASMR), and age-standardized DALYs rates (ASDR) declined for OC and CC, while the ASIR increased and ASDR and ASMR decreased in BC and UC. Socio-demographic index (SDI) regions varied significantly, with high SDI regions having a higher burden of BC and UC. Key risk factors, including high body mass index (BMI) and unsafe sex, significantly contributed to GCs mortality. indicated varied trends for GCs, and projections suggest stable or increasing ASIR for BC and UC over the next 30 years. Conclusions: Our study highlights the growing burden of GCs, with regional disparities and modifiable risk factors. Projections suggest a growing impact of BC and UC, necessitating enhanced global and regional interventions.