Fatemeh Shahbazi

Global socioeconomic inequalities in breast, cervical, ovarian, and uterine cancers incidence, mortality, disability-adjusted life year’s rates: a relative concentration index analysis

This study examined the impact of the Human Development Index (HDI) on the incidence, mortality, and disability-adjusted life-year (DALY) rates of breast and gynecologic cancers in women worldwide. We obtained the 2021 cancer rates by country from the Global Burden of Disease website. Using relative concentration indices and concentration curves, we measured socioeconomic inequality in the mortality, incidence, and DALY rates of these four cancers. We also grouped countries based on their socioeconomic status as measured by the Human Development Index. The incidence, mortality, and DALY rates of uterine and ovarian cancer show higher values in countries with higher levels of HDI (all concentration indices were significantly higher than zero). On the other hand, the incidence, mortality and DALY rates of cervical cancer were more concentrated in countries with lower levels of HDI (all concentration indices were significantly less than zero). No socioeconomic inequality was observed in breast cancer mortality (RCI = 0, 95% confidence interval (CI) = -0.03 to 0.04), there was no significant inequality in breast cancer DALY rates (RCI = 0.02, 95% CI: -0.02 to 0.06), and only breast cancer incidence was significantly concentrated in countries with a high HDI (RCI = 0.09, 95% CI: 0.06 to 0.13). Our study showed that socioeconomic inequalities exist in the distribution of mortality and morbidity from breast and gynecological cancers. Health care policies and facilities to reduce socioeconomic inequalities should focus on areas of high burden.

A meta-analysis of the association between adolescent pregnancy and the risk of gynecological cancers

OBJECTIVES: Despite several investigations, the association between adolescent pregnancy and gynecological cancers has yet to be conclusively established. To further explore this association, we conducted a meta-analysis of observational studies.METHODS: We conducted a comprehensive search of databases such as PubMed, Web of Science, and Scopus to identify studies investigating the link between adolescent pregnancy and gynecologic cancers. This search continued until February 20, 2023. To assess the heterogeneity among the studies, we used the I2-statistics. We also explored the potential presence of publication bias using the Begg and Egger tests. The overall effect sizes were reported as either risk ratio or odds ratio, accompanied by a 95% confidence interval (CI), using a random-effects model.RESULTS: From an initial pool of 25,436 studies, a total of 76 studies involving 13,991,683 participants met the predefined eligibility criteria. The analysis indicated that the overall effect size for individuals having their first pregnancy at age 20 or older, compared to those having it before age 20, was 0.54 (95% CI, 0.50 to 0.59) for cervical cancer, 0.82 (95% CI, 0.77 to 0.88) for ovarian cancer, and 0.96 (95% CI, 0.89 to 1.04) for uterine cancer.CONCLUSIONS: Our findings suggest that experiencing one’s initial pregnancy at the age of 20 or above is associated with a significantly reduced risk of cervical and ovarian cancer. However, no significant association was found between first pregnancy at this age and uterine cancer.